Gait Training Combining Partial Body-Weight Support, a Treadmill, and Functional Electrical Stimulation: Effects on Poststroke Gait

Abstract

Background and Purpose: Treadmill training with harness support is a promising, task-oriented approach to restoring locomotor function in people with poststroke hemiparesis. Although the combined use of functional electrical stimulation (FES) and treadmill training with body-weight support (BWS) has been studied before, this combined intervention was compared with the Bobath approach as opposed to BWS alone. The purpose of this study was to evaluate the effects of the combined use of FES and treadmill training with BWS on walking functions and voluntary limb control in people with chronic hemiparesis. Subjects: Eight people who were ambulatory after chronic stroke were evaluated. Methods: An A1-B-A2 single-case study design was applied. Phases A1 and A2 included 3 weeks of gait training on a treadmill with BWS, and phase B included 3 weeks of treadmill training plus FES applied to the peroneal nerve. The Stroke Rehabilitation Assessment of Movement was used to assess motor recovery, and a videography analysis was used to assess gait parameters. Results: An improvement (from 54.9% to 71.0%) in motor function was found during phase B. The spatial and temporal variables cycle duration, stance duration, and cadence as well as cycle length symmetry showed improvements when phase B was compared with phases A1 and A2. Discussion and Conclusions: The combined use of FES and treadmill training with BWS led to an improvement in motor recovery and seemed to improve the gait pattern of subjects with hemiparesis, indicating the utility of this combination method during gait rehabilitation. In addition, this single-case series showed that this alternative method of gait training—treadmill training with BWS and FES—may decrease the number of people required to carry out the training.

Exercise-mediated locomotor recovery and lower-limb neuroplasticity after stroke

“…In another A-B-A design study of a 9-week protocol, FES was used to augment PBWS TM therapy in a small sample of subjects with chronic stroke. Gait speed, cadence, and stride length increased significantly after the introduction of FES, and gait speed declined when FES was discontinued during a final phase of PBWS TM training only [31]. The potential for early intervention to enhance gait function by combining TM training with robotic assistance and/or FES is promising; however, further studies are needed to delineate optimal methods.…”

Análise do uso de suporte parcial de peso corporal em esteira e em piso fixo durante o andar de crianças com paralisia cerebral

“…Among the different percentages of BWS that can be used, the majority of studies evaluating treadmill walking adopted a 30% BWS due to its effectiveness in improving walking performance [2][3][4][5] . In addition to selecting the appropriate percentage of BWS during training sessions, another aspect to be considered is the type of walking surface, as it should preferably replicate situations encountered during daily life activities in order to facilitate the transfer of skills to that context 6,7 .…”

An Automated Method to Extract Three-Dimensional Position Data Using an Infrared Time-of-Flight Camera

“…The restoration of symmetric gait is a major goal of post-stroke rehabilitation, to allow independent walking and living [2]. Current stroke patient rehabilitation assessments, whether in a clinic or at home, involve subjective, task orientated assessments.…”