Gait training with partial body weight support during overground walking for individuals with chronic stroke: a pilot study

Journal of NeuroEngineering and Rehabilitation, Aug 2011

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.

A PDF file should load here. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a PDF plug-in installed and enabled in your browser.

Alternatively, you can download the file locally and open with any standalone PDF reader:

http://www.jneuroengrehab.com/content/pdf/1743-0003-8-48.pdf

Gait training with partial body weight support during overground walking for individuals with chronic stroke: a pilot study

Journal of NeuroEngineering and Rehabilitation during overground walking for individuals with chronic stroke: a pilot study Catarina O Sousa Jos A Barela Christiane L Prado-Medeiros Tania F Salvini Ana MF Barela Open Access Gait training with partial body weight support during overground walking for individuals with chronic stroke: a pilot study 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. Background Typically, individuals with stroke walk slower than their peers and present asymmetry in spatial-temporal parameters [1,2] and joint angles [3]. These typical characteristics may influence the return of pre-stroke conditions [4], mainly because there exists an increased risk of falling [5], followed by decreases in autonomy, and consequently, an increase in social isolation [6,7]. Therefore, reestablishing independence via walking is a crucial goal of any rehabilitation program for individuals with stroke [3,4,8]. * Correspondence: 3Graduate Program in Human Movement Sciences, Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, So Paulo, SP, Rua Galvo Bueno, 868, 13 andar, Bloco B, 01506-000, So Paulo, SP, Brazil Full list of author information is available at the end of the article Among the different strategies of gait training for individuals with stroke, the use of a partial body weight support (BWS) system has continued to gain popularity [9-13]. This strategy of gait training originated from experiments on animals with complete spinal cord transections [14,15], which established that training on a treadmill promotes the generation of an automatic locomotor pattern by spinal neurons [16,17], named the central pattern generator. Gait training humans affected by stroke using a BWS system on a treadmill increased walking speed and endurance when compared to conventional gait training overground [9] or when using only a treadmill [10]. A BWS system alleviates the body weight of the lower limbs symmetrically [10,18,19], promotes stabilization of the trunk [20], improves balance control, and avoids falls [16]. Most studies had adopted 30% of a subjects body weight unloading due to this percentages effectiveness on gait training [9,12,21,22]. Additionally, the type of training surfaces used by patients is crucial, and this consideration may facilitate skill transfer to daily life activities [23,24]. To our knowledge, no one has evaluated the effects of gait training with partial BWS during overground walking on the walking performance of individuals with stroke. Previous studies concerning BWS during overground walking investigated changes in gait patterns but not its training effects [22,25-27]. Therefore, the purpose of this study was to investigate the effects of gait training on ground level with partial BWS on temporal-spatial parameters and on lower limb and trunk segmental angles of individuals with chronic stroke during overground walking without BWS. It was hypothesized that these individuals gait performance would improve after six weeks of the proposed gait training and they would experience reduced asymmetry. Methods Participants Twenty individuals with chronic stroke discharged from a conventional rehabilitation program at a physical therapy clinic at the university where this study took place volunteered for this study. After an initial evaluation, which occurred one week before the initiation of gait training and consisted of p (...truncated)


This is a preview of a remote PDF: http://www.jneuroengrehab.com/content/pdf/1743-0003-8-48.pdf

Catarina O Sousa, José A Barela, Christiane L Prado-Medeiros, Tania F Salvini, Ana MF Barela. Gait training with partial body weight support during overground walking for individuals with chronic stroke: a pilot study, Journal of NeuroEngineering and Rehabilitation, 2011, pp. 48, 8, DOI: 10.1186/1743-0003-8-48