Effects of Muscle Strengthening and Physical Conditioning Training on Temporal, Kinematic and Kinetic Variables During Gait in Chronic Stroke Survivors

Teixeira-Salmela, Luci Fuscaldi; Nadeau, Sylvie; McBride, I.; Olney, Sandra J.

doi:10.1080/165019701750098867

Cited by 164 publications

(42 citation statements)

References 15 publications

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“…The findings of the present study build upon recent work demonstrating an association between changes in paretic ankle plantarflexor function and improved post-stroke walking speed 44,45 . These studies, consistent with the early work of Olney and colleagues 6 , provide insight into the biomechanical mechanisms that may underlie the improvements in propulsion observed in the present study.…”

Section: Discussionsupporting

confidence: 84%

Targeting Paretic Propulsion to Improve Poststroke Walking Function: A Preliminary Study

Awad¹,

Reisman²,

Kesar³

et al. 2014

Archives of Physical Medicine and Rehabilitation

100

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OBJECTIVE To determine 1) the feasibility and safety of implementing a 12-week locomotor intervention targeting paretic propulsion deficits during walking through the joining of two independent interventions: walking at maximal speed on a treadmill and functional electrical stimulation of the paretic ankle musculature (FastFES), 2) the effects of FastFES training on individual subjects, and 3) the influence of baseline impairment severity on treatment outcomes. DESIGN A single group pre-post preliminary study investigating a novel locomotor intervention. Changes following treatment were assessed using pair-wise comparisons and compared to known minimal clinically important differences (MCIDs) or minimal detectable changes (MDCs). Correlation analyses were run to determine the relationship between baseline clinical and biomechanical performance versus improvements in walking speed. SETTING University clinical research laboratory. PARTICIPANTS Thirteen individuals with locomotor deficits following a stroke. INTERVENTION FastFES training was provided for 12 weeks at a frequency of 3 sessions per week and 30 minutes per session. MAIN OUTCOME MEASURES Measures of gait mechanics, functional balance, short- and long-distance walking function, and self-perceived participation were collected at baseline, post-training, and at a 3 month follow-up. RESULTS Twelve of the 13 subjects recruited completed training. Improvements in paretic propulsion were accompanied by improvements in functional balance, walking function, and self-perceived participation (each p < 0.02) – all of which were maintained at the 3 month follow up. Eleven of the 12 subjects achieved meaningful functional improvements. Baseline impairment was predictive of absolute, but not relative functional change following training. CONCLUSIONS This report demonstrates the safety and feasibility of the FastFES intervention and supports further study of this promising locomotor intervention for persons post-stroke.

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Section: Discussionsupporting

confidence: 84%

Targeting Paretic Propulsion to Improve Poststroke Walking Function: A Preliminary Study

Awad¹,

Reisman²,

Kesar³

et al. 2014

Archives of Physical Medicine and Rehabilitation

100

View full text Add to dashboard Cite

show abstract

“…Studies have shown that adults with stroke do not push effectively with their PF during gait [9,10,11]. FES for hemiplegic gait is typically delivered only to the ankle DF to correct 'foot drop' during the swing phase, thereby failing to address other important stance and swing phase post-stroke gait deficits at the hip and knee [8,12].…”

Section: Discussionmentioning

confidence: 99%

Functional Electrical Stimulation to Ankle Dorsiflexor and Plantarflexor Using Single Foot Switch in Patients With Hemiplegia From Hemorrhagic Stroke

et al. 2014

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ObjectiveTo evaluate the effects of functional electrical stimulation (FES) to ankle dorsiflexor (DF) and ankle plantarflexor (PF) on kinematic and kinetic parameters of hemiplegic gait.MethodsFourteen post-stroke hemiplegic patients were considered in this study. Electrical stimulation was delivered to ankle DF during the swing phase and ankle PF during the stance phase via single foot switch. Kinematic and kinetic data were collected using a computerized motion analysis system with force plate. Data of no stimulation (NS), DF stimulation only (DS), DF and PF stimulation (DPS) group were compared among each other.ResultsPeak ankle dorsiflexion angle during swing phase is significantly greater in DS group (-1.55°±9.10°) and DPS group (-2.23°±9.64°), compared with NS group (-6.71°±11.73°) (p<0.05), although there was no statistically significant difference between DS and DPS groups. Ankle plantarflexion angle at toe-off did not show significant differences among NS, DS, and DPS groups. Peak knee flexion in DPS group (34.12°±13.77°) during swing phase was significantly greater than that of NS group (30.78°±13.64°), or DS group (32.83°±13.07°) (p<0.05).ConclusionIn addition to the usual FES application stimulating ankle DF during the swing phase, stimulation of ankle PF during stance phase can help to increase peak knee flexion during the swing phase. This study shows the advantages of stimulating the ankle DF and PF using single foot switch for post-stroke gait.

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“…13 In addition, it is an important outcome measure of locomotor rehabilitation because it reflects both physical performance and physiological changes, 14,15 remains reliable and sensitive to change even as recovery advances, 16 and is a predictor of health status 17 as well as quality of life. 15 Walking speed has been used as the primary outcome measure for many clinical trials of locomotor-related interventions for persons with stroke, such as exercise therapy, 18 lower extremity strength training, 19,20 functional electrical stimulation, 21 treadmill walking, 22,23 and locomotor training with treadmill and body weight support. 24,25 A recent meta-analysis demonstrated that these approaches, although very different, led to similar gains in walking speed.…”

Section: Assessment Of Task Performancementioning

confidence: 99%

Advancing Measurement of Locomotor Rehabilitation Outcomes to Optimize Interventions and Differentiate Between Recovery Versus Compensation

Bowden

Behrman

Woodbury

et al. 2012

Journal of Neurologic Physical Therapy

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Progress in locomotor rehabilitation has created an increasing need to understand the factors that contribute to motor behavior, to determine whether these factors are modifiable, and if so, to determine how best to modify them in a way that promotes improved function. Currently available measures do not have the capacity to distinguish between neuromotor recovery and compensation for impaired underlying body structure/functions. The purpose of this Special Interest article is to examine the state of outcomes measurement in physical therapy in regards outcomes to locomotor rehabilitation, and to suggest approaches that may improve assessment of recovery and clinical decision-making capabilities. We examine historical approaches to measurement of locomotor rehabilitation outcomes including rating scales, timed movement tasks, and laboratory-based outcome measures, and we discuss the emerging use of portable technology to assess walking in a free living environment. The ability to accurately measure outcomes of rehabilitation, both in and away from the laboratory setting, allows assessment of skill acquisition, retention, and long-term carryover in a variety of environments. Accurate measurement allows behavioral changes to be observed and assessments to be made, not only regarding an individual's ability to adapt during interventions, but also their ability to incorporate new skills into a real-world behavior. The result of such an approach to assessment may be that interventions truly translate from laboratory to real-world environments. Future locomotor measurement tools must be based on a theoretical framework that can guide their use to accurately quantify treatment effects and provide a basis upon which to develop and refine therapeutic interventions.

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Effects of Muscle Strengthening and Physical Conditioning Training on Temporal, Kinematic and Kinetic Variables During Gait in Chronic Stroke Survivors

Cited by 164 publications

References 15 publications

Targeting Paretic Propulsion to Improve Poststroke Walking Function: A Preliminary Study

Targeting Paretic Propulsion to Improve Poststroke Walking Function: A Preliminary Study

Functional Electrical Stimulation to Ankle Dorsiflexor and Plantarflexor Using Single Foot Switch in Patients With Hemiplegia From Hemorrhagic Stroke

Advancing Measurement of Locomotor Rehabilitation Outcomes to Optimize Interventions and Differentiate Between Recovery Versus Compensation

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