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Martini E, Cesini I, D'Abbraccio J, Arnetoli G, Doronzio S, Giffone A, Meoni B, Oddo CM, Vitiello N, Crea S. Increased Symmetry of Lower-Limb Amputees Walking With Concurrent Bilateral Vibrotactile Feedback. IEEE Trans Neural Syst Rehabil Eng 2020; 29:74-84. [PMID: 33125331 DOI: 10.1109/tnsre.2020.3034521] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Gait asymmetry in lower-limb amputees can lead to several secondary conditions that can decrease general health and quality of life. Including augmented sensory feedback in rehabilitation programs can effectively mitigate spatiotemporal gait irregularities. Such benefits can be obtained with non-invasive haptic systems representing an advantageous choice for usability in overground training and every-day life. In this study, we tested a wearable tactile feedback device delivering short-lasting (100ms) vibrations around the waist syncronized to gait events, to improve the temporal gait symmetry of lower-limb amputees. Three above-knee amputees participated in the study. The device provided bilateral stimulations during a training program that involved ground-level gait training. After three training sessions, participants showed higher temporal symmetry when walking with the haptic feedback in comparison to their natural walking (resulting symmetry index increases of +2.8% for Subject IDA, +12.7% for Subject IDB and +2.9% for Subject IDC). One subject retained improved symmetry (Subject IDB,+14.9%) even when walking without the device. Gait analyses revealed that higher temporal symmetry may lead to concurrent compensation strategies in the trunk and pelvis. Overall, the results of this pilot study confirm the potential utility of sensory feedback devices to positively influence gait parameters when used in supervised settings. Future studies shall clarify more precisely the training modalities and the targets of rehabilitation programs with such devices.
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Body weight supported treadmill vs. overground gait training for acute stroke gait rehabilitation. Int J Rehabil Res 2019; 42:270-274. [DOI: 10.1097/mrr.0000000000000357] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gama GL, Celestino ML, Barela JA, Barela AMF. Gait initiation and partial body weight unloading for functional improvement in post-stroke individuals. Gait Posture 2019; 68:305-310. [PMID: 30553152 DOI: 10.1016/j.gaitpost.2018.12.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 10/04/2018] [Accepted: 12/05/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND To better understand gait initiation in individuals with stroke and suggest possible training strategies, we compared the gait initiation of individuals with stroke and age-matched controls, and we examined the influence of different amounts of body weight support (BWS) during the execution of gait initiation in individuals with stroke. MATERIALS AND METHODS Twelve individuals with stroke and 12 age-matched controls initiated gait after a verbal command at a self-selected and comfortable speed, and individuals with stroke also initiated gait wearing a harness with 0%, 15%, and 30% of BWS. Length and velocity of the first step, distance between heels, and weight bearing in both lower limbs in the initial position were calculated. We also assessed the displacement and average velocity of the center of pressure (CoP) in the medial-lateral (ML) and anterior-posterior (AP) directions in 3 distinct sections during gait initiation, which correspond to the CoP position toward the swing limb, stance limb and progression line, respectively. RESULTS Individuals with stroke presented shorter and slower step, shorter and slower CoP-ML and CoP-AP toward swing limb and Cop-ML towards stance limb, and longer and faster CoP-AP toward stance limb compared to their peers. The BWS lead individuals with stroke to decrease step length and to increase CoP-ML displacement and average velocity toward stance limb. CONCLUSION Individuals with stroke present impairments in executing gait initiation mainly during the preparation period and the employment of an overground BWS system promotes a better performance. These results suggest that BWS is a functional strategy that enables individuals with stroke to modulate gait initiation and it could be adopted for gait intervention.
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Affiliation(s)
- Gabriela L Gama
- Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, São Paulo, SP, Brazil
| | - Melissa L Celestino
- Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, São Paulo, SP, Brazil
| | - José A Barela
- Department of Physical Education, São Paulo State University, Rio Claro, SP, Brazil
| | - Ana M F Barela
- Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, São Paulo, SP, Brazil.
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Betschart M, McFayden BJ, Nadeau S. Lower limb joint moments on the fast belt contribute to a reduction of step length asymmetry over ground after split-belt treadmill training in stroke: A pilot study. Physiother Theory Pract 2018; 36:989-999. [DOI: 10.1080/09593985.2018.1530708] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Martina Betschart
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR), Institut de Réadaptation Gingras-Lindsay de Montréal (IRGLM), CIUSSS Centre-Sud-de-l’Île-de-Montréal, Québec, Canada
- École de Réadaptation, Université de Montréal, Québec, Canada
| | - Bradford J. McFayden
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), CIUSSS de la Capitale-Nationale, Québec, Canada
- Département de Réadaptation, Faculté de Médecine, Université de Laval, Québec, Canada
| | - Sylvie Nadeau
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR), Institut de Réadaptation Gingras-Lindsay de Montréal (IRGLM), CIUSSS Centre-Sud-de-l’Île-de-Montréal, Québec, Canada
- École de Réadaptation, Université de Montréal, Québec, Canada
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Kang TW, Oh DW, Lee JH, Cynn HS. Rhythmic arm swing integrated into treadmill training in patients with chronic stroke: A single-subject experimental study. Physiother Theory Pract 2018; 34:613-621. [PMID: 29336648 DOI: 10.1080/09593985.2017.1423430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Normal walking includes coordinated and controlled movement of the legs and arms. However, patients following stroke often present with inappropriate motor control which limits coordinated movement patterns of the affected limbs. This study aimed to compare the effects of rhythmic arm swing and arm fixation during treadmill walking in patients with poststroke hemiparesis. We used an alternating study design with multiple baselines across subjects. Three patients with chronic stroke participated in this study. During treadmill walking, rhythmic arm swing and arm fixation conditions were alternately applied. Outcome measures included the 10-meter walk test (10MWT) and energy expenditure index (EEI). In the intervention phase, all subjects showed significantly greater improvements in the 10MWT and EEI scores for rhythmic arm swing condition compared to those for arm fixation condition (p < 0.05). 10MWT improvement rates: Subject 1-34.81% vs. 15.75%; Subject 2-40.00% vs. 17.95%; and Subject 3-38.08% vs. 21.85%; and EEI improvements: Subject 1-23.19% vs. 14.08%; Subject 2-26.15% vs. 20.43%; and Subject 3-22.99% vs. 14.49%. These findings suggest that rhythmic arm swing is clinically feasible as a more favorable option to enhance the effects of treadmill walking training. However, larger studies with a different study design are needed to be able to make any judgment about the usefulness of the treatment.
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Affiliation(s)
- Tae-Woo Kang
- a Department of Physical Therapy , Wonkwang University School Of Medicine & Hospital , Iksan , Jeollabuk-do , Republic of Korea
| | - Duck-Won Oh
- b Department of Physical Therapy, College of Health Science , Cheongju University , Cheongju , Chungcheongbuk-do , Republic of Korea
| | - Ji-Hyun Lee
- c Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy , Graduate School, Yonsei University , Wonju , Kangwon-do , Republic of Korea
| | - Heon-Seok Cynn
- c Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy , Graduate School, Yonsei University , Wonju , Kangwon-do , Republic of Korea
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Jung T, Kim Y, Lim H, Vrongistinos K. The influence of water depth on kinematic and spatiotemporal gait parameters during aquatic treadmill walking. Sports Biomech 2018; 18:297-307. [PMID: 29334869 DOI: 10.1080/14763141.2017.1409255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of this study was to investigate kinematic and spatiotemporal variables of aquatic treadmill walking at three different water depths. A total of 15 healthy individuals completed three two-minute walking trials at three different water depths. The aquatic treadmill walking was conducted at waist-depth, chest-depth and neck-depth, while a customised 3-D underwater motion analysis system captured their walking. Each participant's self-selected walking speed at the waist level was used as a reference speed, which was applied to the remaining two test conditions. A repeated measures ANOVA showed statistically significant differences among the three walking conditions in stride length, cadence, peak hip extension, hip range of motion (ROM), peak ankle plantar flexion and ankle ROM (All p values < 0.05). The participants walked with increased stride length and decreased cadence during neck level as compared to waist and chest level. They also showed increased ankle ROM and decreased hip ROM as the water depth rose from waist and chest to the neck level. However, our study found no significant difference between waist and chest level water in all variables. Hydrodynamics, such as buoyancy and drag force, in response to changes in water depths, can affect gait patterns during aquatic treadmill walking.
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Affiliation(s)
- Taeyou Jung
- a Department of Kinesiology , California State University , Northridge , CA , USA
| | - Yumi Kim
- a Department of Kinesiology , California State University , Northridge , CA , USA
| | - Hyosok Lim
- a Department of Kinesiology , California State University , Northridge , CA , USA
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Exploration of Two Training Paradigms Using Forced Induced Weight Shifting With the Tethered Pelvic Assist Device to Reduce Asymmetry in Individuals After Stroke: Case Reports. Am J Phys Med Rehabil 2017; 96:S135-S140. [PMID: 28661914 DOI: 10.1097/phm.0000000000000779] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Many robotic devices in rehabilitation incorporate an assist-as-needed haptic guidance paradigm to promote training. This error reduction model, while beneficial for skill acquisition, could be detrimental for long-term retention. Error augmentation (EA) models have been explored as alternatives. A robotic Tethered Pelvic Assist Device has been developed to study force application to the pelvis on gait and was used here to induce weight shift onto the paretic (error reduction) or nonparetic (error augmentation) limb during treadmill training. The purpose of these case reports is to examine effects of training with these two paradigms to reduce load force asymmetry during gait in two individuals after stroke (>6 mos). Participants presented with baseline gait asymmetry, although independent community ambulators. Participants underwent 1-hr trainings for 3 days using either the error reduction or error augmentation model. Outcomes included the Borg rating of perceived exertion scale for treatment tolerance and measures of force and stance symmetry. Both participants tolerated training. Force symmetry (measured on treadmill) improved from pretraining to posttraining (36.58% and 14.64% gains), however, with limited transfer to overground gait measures (stance symmetry gains of 9.74% and 16.21%). Training with the Tethered Pelvic Assist Device device proved feasible to improve force symmetry on the treadmill irrespective of training model. Future work should consider methods to increase transfer to overground gait.
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Lee J, Lee K, Song C. Speed-Interactive Treadmill Training Using Smartphone-Based Motion Tracking Technology Improves Gait in Stroke Patients. J Mot Behav 2017. [PMID: 28632106 DOI: 10.1080/00222895.2016.1271300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study was conducted to investigate the effects of speed-interactive treadmill training (SITT) using smartphone-based motion tracking technology on gait in stroke patients. Thirty-four chronic stroke patients were randomly divided into a SITT group (n = 18) and a standard treadmill training (control) group (n = 16). The SITT group underwent smartphone-based SSIT while the control group underwent standard treadmill training. Both groups performed the training for 35 min per session, 3 times per week, for 6 weeks. Both groups used nonmotorized treadmills so that patients could control the speed. Evaluation was conducted during the week before and after the training. The OptoGait system measured gait spatiotemporal parameters. Both groups showed significant improvement in the temporal and spatial gait parameters (p < .05). In the SITT group, compared to the control group, the two-way analysis of variance with repeated measures showed an improvement in the temporal and spatial gait parameters after the intervention period (p < .05). This study confirmed that SITT improved the gait function of stroke patients. Based on this result, the authors propose that SITT, by improving gait, can be used as an effective training method to improve patients' functional activities in the clinic.
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Affiliation(s)
- Junyoung Lee
- a Department of Physical Therapy , College of Health Science, Sahmyook University , Seoul , Republic of Korea
| | - Kyeongjin Lee
- b Department of Physical Therapy , Kyungdong University , Gangwon Province , Republic of Korea
| | - Changho Song
- a Department of Physical Therapy , College of Health Science, Sahmyook University , Seoul , Republic of Korea
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Edwards T, Pilutti LA. The effect of exercise training in adults with multiple sclerosis with severe mobility disability: A systematic review and future research directions. Mult Scler Relat Disord 2017; 16:31-39. [PMID: 28755682 DOI: 10.1016/j.msard.2017.06.003] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 05/10/2017] [Accepted: 06/09/2017] [Indexed: 12/30/2022]
Abstract
INTRODUCTION There is evidence for the benefits of exercise training in persons with multiple sclerosis (MS). However, these benefits have primarily been established in individuals with mild-to-moderate disability (i.e., Expanded Disability Status Scale [EDSS] scores 1.0-5.5), rather than among those with significant mobility impairment. Further, the approaches to exercise training that have been effective in persons with mild-to-moderate MS disability may not be physically accessible for individuals with mobility limitations. Therefore, there is a demand for an evidence-base on the benefits of physically accessible exercise training approaches for managing disability in people with MS with mobility impairment. OBJECTIVE To conduct a systematic review of the current literature pertaining to exercise training in individuals with multiple sclerosis (MS) with severe mobility disability. METHODS Four electronic databases (PubMed, EMBASE, OvidMEDLINE, and PsychINFO) were searched for relevant articles published up until October 2016. The review focused on English-language studies that examined the effect of exercise training in people with MS with severe mobility disability, characterized as the need for assistance in ambulation or EDSS score ≥ 6.0. The inclusion criteria involved full-text articles that: (i) included participants with a diagnosis of MS; (ii) included primarily participants with a reported EDSS score ≥ 6.0 and/or definitively described disability consistent with this level of neurological impairment; and (iii) implemented a prospective, structured exercise intervention. Data were analyzed using a descriptive approach and summarized by exercise training modality (conventional or adapted exercise training), and by outcome (disability, physical fitness, physical function, and symptoms and participation). RESULTS Initially, 1164 articles were identified and after removal of duplicates, 530 articles remained. In total, 512 articles did not meet the inclusion criteria. 19 articles were included in the final review. Five studies examined conventional exercise training (aerobic and resistance training), and thirteen studies examined adapted exercise modalities including body-weight support treadmill training (BWSTT), total-body recumbent stepper training (TBRST), and electrical stimulation cycling (ESAC). Outcomes related to mobility, fatigue, and quality of life (QOL) were most frequently reported. Two of five studies examining conventional resistance exercise training reported significant improvements in physical fitness, physical function, and/or symptomatic and participatory outcomes. Nine of 13 studies examining adapted exercise training reported significant improvements in disability, physical fitness, physical function, and/or symptomatic and participatory outcomes. CONCLUSIONS There is limited, but promising evidence for the benefits of exercise training in persons with MS with severe mobility disability. Considering the lack of effective therapeutic strategies for managing long-term disability accumulation, exercise training could be considered as an alternative approach. Further research is necessary to optimize the prescription and efficacy of exercise training for adults with MS with severe mobility disability.
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Affiliation(s)
- Thomas Edwards
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, Ontario, Canada K1N 6N5.
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Ma Y, Xie S, Zhang Y. A patient-specific EMG-driven neuromuscular model for the potential use of human-inspired gait rehabilitation robots. Comput Biol Med 2016; 70:88-98. [DOI: 10.1016/j.compbiomed.2016.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 01/01/2016] [Accepted: 01/04/2016] [Indexed: 10/22/2022]
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Effects of treadmill inclination on hemiparetic gait: controlled and randomized clinical trial. Am J Phys Med Rehabil 2015; 94:718-27. [PMID: 25357148 DOI: 10.1097/phm.0000000000000240] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the effects of inclined treadmill training on the kinematic characteristics of gait in subjects with hemiparesis. DESIGN A blind, randomized, controlled study was conducted with 28 subjects divided into two groups: the control group, submitted to partial body weight-support treadmill gait training with no inclination, and the experimental group, which underwent partial body weight-support treadmill training at 10% of inclination. All volunteers were assessed for functional independence, motor function, balance, and gait before and after the 12 training sessions. RESULTS Both groups showed posttraining alterations in balance (P < 0.001), motor function (P < 0.001), and functional independence (P = 0.002). Intergroup differences in spatiotemporal differences were observed, where only the experimental group showed posttraining alterations in velocity (P = 0.02) and paretic step length (P = 0.03). Angular variables showed no significant differences in either group. CONCLUSIONS In subjects with hemiparesis, the addition of inclination is a stimulus capable of enhancing the effects of partial body weight-support treadmill gait training.
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Sousa CO, Barela JA, Prado-Medeiros CL, Salvini TF, Barela AMF. Gait training with partial body weight support during overground walking for individuals with chronic stroke: a pilot study. J Neuroeng Rehabil 2011; 8:48. [PMID: 21864373 PMCID: PMC3173296 DOI: 10.1186/1743-0003-8-48] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 08/24/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is not yet established if the use of body weight support (BWS) systems for gait training is effective per se or if it is the combination of BWS and treadmill that improves the locomotion of individuals with gait impairment. This study investigated the effects of gait training on ground level with partial BWS in individuals with stroke during overground walking with no BWS. METHODS Twelve individuals with chronic stroke (53.17 ± 7.52 years old) participated of a gait training program with BWS during overground walking, and were evaluated before and after the gait training period. In both evaluations, individuals were videotaped walking at a self-selected comfortable speed with no BWS. Measurements were obtained for mean walking speed, step length, stride length and speed, toe-clearance, durations of total double stance and single-limb support, and minimum and maximum foot, shank, thigh, and trunk segmental angles. RESULTS After gait training, individuals walked faster, with symmetrical steps, longer and faster strides, and increased toe-clearance. Also, they displayed increased rotation of foot, shank, thigh, and trunk segmental angles on both sides of the body. However, the duration of single-limb support remained asymmetrical between each side of the body after gait training. CONCLUSIONS Gait training individuals with chronic stroke with BWS during overground walking improved walking in terms of temporal-spatial parameters and segmental angles. This training strategy might be adopted as a safe, specific and promising strategy for gait rehabilitation after stroke.
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Affiliation(s)
- Catarina O Sousa
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Rodovia Washington Luis, Km 235, CP, 676, 13656-905, São Carlos, SP, Brazil
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Kim CS, Gong W, Kim SG. The Effects of Lower Extremitiy Muscle Strengthening Exercise and Treadmill Walking Exercise on the Gait and Balance of Stroke Patients. J Phys Ther Sci 2011. [DOI: 10.1589/jpts.23.405] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Chang Sook Kim
- Physical Therapy, Department of Rehabilitation Science, Graduate School of Daegu Univestiy
| | - Wontae Gong
- Department of Physical Therapy, Gumi College
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Burgess JK, Weibel GC, Brown DA. Overground walking speed changes when subjected to body weight support conditions for nonimpaired and post stroke individuals. J Neuroeng Rehabil 2010; 7:6. [PMID: 20149244 PMCID: PMC2827418 DOI: 10.1186/1743-0003-7-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2009] [Accepted: 02/11/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research has shown that body weight support (BWS) has the potential to improve gait speed for individuals post-stroke. However, body weight support also reduces the optimal walking speed at which energy use is minimized over the gait cycle indicating that BWS should reduce walking speed capability. METHODS Nonimpaired subjects and subjects post-stroke walked at a self-selected speed over a 15 m walkway. Body weight support (BWS) was provided to subjects at 0%, 10%, 20%, 30%, and 40% of the subject's weight while they walked overground using a robotic body weight support system. Gait speed, cadence, and average step length were calculated for each subject using recorded data on their time to walk 10 m and the number of steps taken. RESULTS When subjected to greater levels of BWS, self-selected walking speed decreased for the nonimpaired subjects. However, subjects post-stroke showed an average increase of 17% in self-selected walking speed when subjected to some level of BWS compared to the 0% BWS condition. Most subjects showed this increase at the 10% BWS level. Gait speed increases corresponded to an increase in step length, but not cadence. CONCLUSIONS The BWS training environment results in decreased self-selected walking speed in nonimpaired individuals, however self-selected overground walking speed is facilitated when provided with a small percentage of body weight support for people post-stroke.
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Affiliation(s)
- Jamie K Burgess
- Department Of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Gwendolyn C Weibel
- Sensory Motor Performance Program, The Rehabilitation Institute of Chicago, Chicago, IL, USA
| | - David A Brown
- Department Of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
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Goldstein LB. Stroke recovery and rehabilitation. HANDBOOK OF CLINICAL NEUROLOGY 2009; 94:1327-1337. [PMID: 18793903 DOI: 10.1016/s0072-9752(08)94066-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Larry B Goldstein
- Duke Center for Cerebrovascular Disease and Durham VA Medical Center, Durham, NC 27710, USA.
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Tuckey J, Greenwood R. Rehabilitation after severe Guillain–Barré syndrome: the use of partial body weight support. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2006; 9:96-103. [PMID: 15317424 DOI: 10.1002/pri.306] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Jo Tuckey
- Physiotherapy Department, Regional Neurological Rehabilitation Unit, Homerton Hospital, London, UK
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Kim CM, Eng JJ. Symmetry in vertical ground reaction force is accompanied by symmetry in temporal but not distance variables of gait in persons with stroke. Gait Posture 2003; 18:23-8. [PMID: 12855297 DOI: 10.1016/s0966-6362(02)00122-4] [Citation(s) in RCA: 190] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The purpose of this study was to (1) determine whether symmetry in temporal-distance (T-D) measures is accompanied by symmetry in kinetic measures during self-paced gait and (2) evaluate the effect of symmetry on gait speed in individuals with chronic stroke. A symmetry index was calculated for stance time, swing time, step length and vertical ground reaction force (GRF) for 28 individuals with stroke (age: 62.5+/-8.2 years). Spearman correlation revealed that (a) gait speed was correlated with the symmetry of temporal measures and GRF and (b) symmetry in GRF was correlated with symmetry in temporal but not distance measures of gait (P<0.05). The results provide support for promoting temporal and kinetic symmetry in the gait of persons with stroke.
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Affiliation(s)
- C Maria Kim
- Rehabilitation Research Laboratory, School of Rehabilitation Sciences, University of BC, T325-2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5
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Barbeau H, Norman K, Fung J, Visintin M, Ladouceur M. Does neurorehabilitation play a role in the recovery of walking in neurological populations? Ann N Y Acad Sci 1998; 860:377-92. [PMID: 9928326 DOI: 10.1111/j.1749-6632.1998.tb09063.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This review demonstrates that neurorehabilitation approaches, based on recent neuroscience findings, can enhance locomotor recovery after a spinal cord injury or stroke. Findings are presented from more than 20 clinical studies conducted by numerous research groups on the effect of locomotor training using either body weight support (BWS), functional electrical stimulation (FES), pharmacological approaches or a combination of them. Among the approaches, only BWS-assisted locomotor training has been demonstrated to have a greater effect than conventional or locomotor training alone. However, when study results were combined and weighted for the number of subjects, the results indicated that there is a gradient of effects from small changes with the immediate application of FES or BWS to larger changes when locomotor training is combined with FES or BWS or pharmacological approaches. The findings of these studies suggest that these neurorehabilitation approaches do play a role in the recovery of walking in subjects with spinal cord injury or stroke. Several factors contribute to the potential for recovery including the site, etiology, and chronicity of the injury, as well as the type, duration, and specificity of the intervention and whether interventions are combined. Furthermore, how these neurorehabilitation approaches may take advantage of the plasticity process following neurological lesion is also discussed.
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Affiliation(s)
- H Barbeau
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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