Walking during body-weight-supported treadmill training and acute responses to varying walking speed and body-weight support in ambulatory patients post-stroke

Rehabilitating walking in ambulatory patients post-stroke, with training that is safe, task-specific, intensive, and of sufficient duration, can be challenging. Some challenges can be met by using body-weight-supported treadmill training (BWSTT). However, it is not known to what degree walking chara...

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Bibliographic Details
Published in:Physiotherapy theory and practice 2013-05, Vol.29 (4), p.278-289
Main Authors: Aaslund, Mona Kristin, Helbostad, Jorunn Lægdheim, Moe-Nilssen, Rolf
Format: Article
Language:English
Subjects:
Aged
Analysis of Variance
Biomechanical Phenomena
Cross-Sectional Studies
Exercise Test
Exercise Therapy
Female
Gait
Humans
Kinematics
Male
Middle Aged
Predictive Value of Tests
Rehabilitation
Stroke - diagnosis
Stroke - physiopathology
Stroke Rehabilitation
Strokes
Therapists
Treatment Outcome
Walking
Walking speed
Weight-Bearing
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Summary:Rehabilitating walking in ambulatory patients post-stroke, with training that is safe, task-specific, intensive, and of sufficient duration, can be challenging. Some challenges can be met by using body-weight-supported treadmill training (BWSTT). However, it is not known to what degree walking characteristics are similar during BWSTT and overground walking. In addition, important questions regarding the training protocol of BWSTT remain unanswered, such as how proportion of body-weight support (BWS) and walking speed affect walking characteristics during training. The objective was therefore to investigate if and how kinematic walking characteristics are different between overground walking and treadmill walking with BWS in ambulatory patients post-stroke, and the acute response of altering walking speed and percent BWS during treadmill walking with BWS. A cross-sectional repeated-measures design was used. Ambulating patients post-stroke walked in slow, preferred, and fast walking speed overground and at comparable speeds on the treadmill with 20% and 40% BWS. Kinematic walking characteristics were obtained using a kinematic sensor attached over the lower back. Forty-four patients completed the protocol. Kinematic walking characteristics were similar during treadmill walking with BWS, compared to walking overground. During treadmill walking, choice of walking speed had greater impact on kinematic walking characteristics than proportion of BWS. Faster walking speeds tended to affect the kinematic walking characteristics positively. This implies that in order to train safely and with sufficient intensity and duration, therapists may choose to include BWSTT in walking rehabilitation also for ambulatory patients post-stroke without aggravating gait pattern during training.
ISSN:0959-3985
1532-5040
DOI:10.3109/09593985.2012.727526