Gait symmetry and functional walking performance in hemiparetic patients prior to and after a 4-week rehabilitation programme

Hesse, S.; Jahnke, M.T.; Schreiner, Christoph E.; Mauritz, Karl Heinz

doi:10.1016/0966-6362(93)90059-a

Cited by 37 publications

(14 citation statements)

References 13 publications

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“…In 1993–94, Hesse et al . found that there was no significant improvement in gait symmetry parameters after an intensive 4 week inpatient training programme (Hesse et al ., 1993; Hesse et al ., 1994b). One explanation of this lack of improvement may lie in the nature of the therapy itself.…”

Section: Gait Training – Methodologiesmentioning

confidence: 99%

Gait training in hemiplegia

Mauritz

2002

Euro J of Neurology

132

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Restoration of gait is a major goal in neurological rehabilitation. Before starting therapy, a comprehensive assessment is necessary to evaluate the deficits and remaining functions. A wide variety of therapeutic procedures are available and have to be adapted to the individual situation - different concepts of physiotherapy stress different features like: force exercise, reduction of spasticity, gait symmetry, utilization of equilibrium reflexes, stepping automation, endurance training, repetition of rhythmic movements, etc. The spectrum of available therapies was recently widened by treadmill training, with partial body-weight support, locomotor pharmacotherapy, selective reduction of spasticity by botulinum toxin injections, and by musical biofeedback, which have each proved to be successful in the restoration of gait pattern. Treadmill training based on partial body weight support, combined with enforced stepping movements has proved to be successful in the restoration of gait pattern. A common problem in hemiparetic gait, is the spastic inversion of the foot. If spasticity is not severe, an ankle-foot orthosis (AFO) is the appropriate technical aid. In other cases, botulinum toxin injection into spastic leg muscles has been successfully used to improve gait functions. In hemiparetic stroke patients, auditory (musical) rhythm, as a peripheral pacing signal, resulted in a significant increase in weight-bearing stance time on the paretic side. In addition, there was an improved stride symmetry with rhythmic cueing and a normalizations of gait pattern. These methods directed to gait improvement should be combined and adapted to the individual patient's needs, in order to obtain the best results.

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Section: Gait Training – Methodologiesmentioning

confidence: 99%

Gait training in hemiplegia

Mauritz

2002

Euro J of Neurology

132

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“…Indeed, reducing asymmetry is a common goal of rehabilitation post-stroke 4,13,14 , and this approach implicitly assumes that symmetric gait is somehow advantageous for these individuals. However, only recently have approaches for improving step length symmetry become available.…”

Section: Introductionmentioning

confidence: 99%

Associations Between Foot Placement Asymmetries and Metabolic Cost of Transport in Hemiparetic Gait

Finley

Bastian

2016

Neurorehabil Neural Repair

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Stroke survivors often have a slow, asymmetric walking pattern. They also walk with a higher metabolic cost than healthy, age-matched controls. It is often assumed that spatial-temporal asymmetries contribute to the increased metabolic cost of walking post-stroke. However, elucidating this relationship is made challenging due to the interdependence between spatial-temporal asymmetries, walking speed, and metabolic cost. Here, we address these potential confounds by measuring speed-dependent changes in metabolic cost and implementing a recently developed approach to dissociate spatial versus temporal contributions to asymmetry in a sample of stroke survivors. We used expired gas analysis to compute the metabolic cost of transport (CoT) for each participant at four different walking speeds: self-selected speed, 80% and 120% of their self-selected speed, and their fastest comfortable speed. We also computed CoT for a sample of age- and gender-matched control participants who walked at the same speeds as their matched stroke survivor. Kinematic data were used to compute the magnitude of a number of variables characterizing spatial-temporal asymmetries. Across all speeds, stroke survivors had a higher CoT than controls. We also found that our sample of stroke survivors did not choose a self-selected speed that minimized CoT, contrary to typical observations in healthy controls. Multiple regression analyses revealed a negative associations between speed and CoT, and a positive association between asymmetries in foot placement relative to the trunk and CoT. These findings suggest that interventions designed to increase self-selected walking speed and reduce foot-placement asymmetries may be ideal for improving walking economy post-stroke.

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“…Hesse y cols. refieren mejorías en la funcionalidad de la marcha, aunque concluyen que no hay cambios significativos en el patrón ni en la simetría de las marcha (31). Para Benito también se producen cambios significativos en la funcionalidad de la marcha en una distancia larga, este estudio no refiere cambios significativos en distancias cortas ni en la fuerza a nivel muscular (32).…”

Section: Discussionunclassified

Revisión del abordaje terapéutico mediante el principio vojta sobre las alteraciones de la marcha en pacientes neurológicos

Esteban¹,

Sanz²,

Jorge³

et al. 2017

Eur J Pod

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Review of the therapeutic approach by the vojta principle in neurological patients with gait disordersRevisión del abordaje terapéutico mediante el principio vojta sobre las alteraciones de la marcha en pacientes neurológicos Results: After using the criteria of inclusion and exclusion were collected 3 thesis, 35 articles and 7 relevant books of different databases. During the reflex locomotion therapy (RLT), the central nervous system (CNS) seems to be activated probably due to the influence of the posture and stimulus points. All the afferent propioceptive information could cause an innate response in locomotion coordination complex which humans use during gait. Conclusions:Patients with neurological disorders could be improved by the of Vojta therapy in different gait parameters. Vojta therapy (VT) could obtain the activation of cortical and subcortical levels that intervenes during locomotion. More randomized clinical trial are necessary to increase the evidence about Vojta therapy in gait pattern of neurological diseases.Key Words: Physical therapy modalities, gait disorders, neurologic, locomotion, gait rehabilitation, cerebral stroke, cerebral palsy, multiple sclerosis. ResumenObjetivos: Revisar en la bibliografía el abordaje terapéutico del principio Vojta y la importancia de la activación de los programas motores innatos para la mejora funcional de la marcha. Métodos: Se recopilan los datos tras una búsqueda en las bases PUBMED, MEDLINE, otros recursos como Google Scholar y la biblioteca de la Universidad Europea de Madrid, siguiendo los criterios Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) y checklist. Se recogen los datos durante los meses de enero y febrero del 2017. Resultados: Tras aplicar los criterios de inclusión y exclusión resultan relevantes 3 tesis doctorales, 35 artículos y 7 libros de las distintas bases de datos. Durante la terapia de locomoción refleja (TLR) parece producirse una importante activación del sistema nervioso central (SNC) posiblemente debido a la influencia de la postura y la activación de los puntos de estímulo. Toda la información aferente propioceptiva podría provocar la respuesta innata de los complejos de coordinación locomotores que utiliza el ser humano durante la marcha. Conclusiones: Los pacientes con alteraciones neurológicas podrían beneficiarse de la terapia Vojta (TV) al obtener mejorías en diferentes parámetros de la marcha. La TV podría conseguir activar zonas a nivel cortical y subcortical que intervienen durante el movimiento locomotor. Son necesarios ensayos clínicos aleatorizados que aumenten la evidencia científica de la terapia Vojta en los patrones de marcha de patologías neurológicas.Palabras Clave: Fisioterapia, locomoción, rehabilitación de la marcha, alteraciones de la marcha, neurológicas, daño cerebral, parálisis cerebral, esclerosis múltiple.

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Gait symmetry and functional walking performance in hemiparetic patients prior to and after a 4-week rehabilitation programme

Cited by 37 publications

References 13 publications

Gait training in hemiplegia

Gait training in hemiplegia

Associations Between Foot Placement Asymmetries and Metabolic Cost of Transport in Hemiparetic Gait

Revisión del abordaje terapéutico mediante el principio vojta sobre las alteraciones de la marcha en pacientes neurológicos

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