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stroke gait

Nina Lefeber, Eva Swinnen, Eric Kerckhofs
PURPOSE: The integration of sufficient cardiovascular stress into robot-assisted gait (RAG) training could combine the benefits of both RAG and aerobic training. The aim was to summarize literature data on the immediate effects of RAG compared to walking without robot-assistance on metabolic-, cardiorespiratory- and fatigue-related parameters. METHODS: PubMed and Web of Science were searched for eligible articles till February 2016. Means, SDs and significance values were extracted...
October 20, 2016: Disability and Rehabilitation. Assistive Technology
Paul Whelton
BACKGROUND: Choice of the optimal target for blood pressure (BP) reduction during treatment of patients with hypertension, including those with underlying co-morbid conditions, is an important challenge in clinical practice. The Systolic Blood Pressure Intervention Trial (SPRINT) was designed to provide guidance in selection of a Systolic BP target during treatment of hypertension. METHODS: Adults ≥50 years old with hypertension and at least one additional risk factor for cardiovascular disease (CVD), but excluding persons with diabetes mellitus, prior stroke, or advanced chronic kidney disease (CKD) were randomly assigned to intensive therapy (intensive), targeting a systolic BP (SBP) <120 mmHg, or standard therapy (standard), targeting a SBP <140 mmHg...
September 2016: Journal of Hypertension
Eun Young Han, Sang Hee Im, Bo Ryun Kim, Min Ji Seo, Myeong Ok Kim
OBJECTIVE: Brachial-ankle pulse wave velocity (baPWV) evaluates arterial stiffness and also predicts early outcome in stroke patients. The objectives of this study were to investigate arterial stiffness of subacute nonfunctional ambulatory stroke patients and to compare the effects of robot-assisted gait therapy (RAGT) combined with rehabilitation therapy (RT) on arterial stiffness and functional recovery with those of RT alone. METHOD: The RAGT group (N = 30) received 30 minutes of robot-assisted gait therapy and 30 minutes of conventional RT, and the control group (N = 26) received 60 minutes of RT, 5 times a week for 4 weeks...
October 2016: Medicine (Baltimore)
Fan Zhang, Peter Bohlen, Michael D Lewek, He Huang
This study investigated the feasibility of predicting intrinsically caused trips (ICTs) in individuals with stroke. Gait kinematics collected from twelve individuals with chronic stroke, who demonstrated ICTs in treadmill walking, were analyzed. A prediction algorithm based on the outlier principle was employed. Sequential forward selection (SFS) and minimum-redundancy- maximum-relevance (mRMR) were used separately to identify the precursors for accurate ICT prediction. The results showed that it was feasible to predict ICTs around 50- 260ms before ICTs occurred in the swing phase by monitoring lower limb kinematics during the preceding stance phase...
October 11, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Sangeetha Madhavan, James W Stinear, Neeta Kanekar
Objective. High intensity interval treadmill training (HIITT) has been gaining popularity for gait rehabilitation after stroke. In this study, we examined the changes in excitability of the lower limb motor cortical representation (M1) in chronic stroke survivors following a single session of HIITT. We also determined whether exercise-induced changes in excitability could be modulated by transcranial direct current stimulation (tDCS) enhanced with a paretic ankle skill acquisition task. Methods. Eleven individuals with chronic stroke participated in two 40-minute treadmill-training sessions: HIITT alone and HITT preceded by anodal tDCS enhanced with a skill acquisition task (e-tDCS+HIITT)...
2016: Neural Plasticity
Terry Trinh, Christine T Shiner, Angelica G Thompson-Butel, Penelope A McNulty
PURPOSE: Post-stroke hemiparesis may manifest as asymmetric gait, poor balance, and inefficient movement patterns. We investigated improvements in lower-limb muscle activation and function during Wii-based Movement Therapy (WMT), a rehabilitation program specifically targeting upper-limb motor-function. METHODS: Electromyography (EMG) was recorded bilaterally from tibialis anterior (TA) in 20 stroke patients during a 14-day WMT program. EMG amplitude and burst duration were analyzed during stereotypical movement sequences of WMT activities...
October 9, 2016: Disability and Rehabilitation
Maijke van Bloemendaal, Sicco A Bus, Charlotte E de Boer, Frans Nollet, Alexander C H Geurts, Anita Beelen
BACKGROUND: Many stroke survivors suffer from paresis of lower limb muscles, resulting in compensatory gait patterns characterised by asymmetries in spatial and temporal parameters and reduced walking capacity. Functional electrical stimulation has been used to improve walking capacity, but evidence is mostly limited to the orthotic effects of peroneal functional electrical stimulation in the chronic phase after stroke. The aim of this study is to investigate the therapeutic effects of up to 10 weeks of multi-channel functional electrical stimulation (MFES)-assisted gait training on the restoration of spatiotemporal gait symmetry and walking capacity in subacute stroke patients...
October 1, 2016: Trials
Hyun-Ju Park, Duck-Won Oh, Jong-Duk Choi, Jong-Man Kim, Suhn-Yeop Kim, Yong-Jun Cha, Su-Jin Jeon
PURPOSE: To investigate the effects of action observation training involving community-based ambulation for improving walking ability after stroke. DESIGN: Randomized, controlled pilot study. SETTING: Inpatient rehabilitation hospital. SUBJECTS: A total of 25 inpatients with post-stroke hemiparesis were randomly assigned to either the experimental group (n = 12) or control group (n = 13). INTERVENTION: Subjects of the experimental group watched video clips demonstrating four-staged ambulation training with a more complex environment factor for 30 minutes, three times a week for four weeks...
October 5, 2016: Clinical Rehabilitation
Mario Munoz-Organero, Jack Parker, Lauren Powell, Susan Mawson
Insole pressure sensors capture the different forces exercised over the different parts of the sole when performing tasks standing up such as walking. Using data analysis and machine learning techniques, common patterns and strategies from different users to achieve different tasks can be automatically extracted. In this paper, we present the results obtained for the automatic detection of different strategies used by stroke survivors when walking as integrated into an Information Communication Technology (ICT) enhanced Personalised Self-Management Rehabilitation System (PSMrS) for stroke rehabilitation...
October 1, 2016: Sensors
Andoret van Wyk, Carina A Eksteen, Piet J Becker, Barbara M Heinze
INTRODUCTION: Visual impairment, specifically eye movement disorders and vestibular dysfunction may have a negative influence on the functional recovery in post-stroke patients. This type of sensory dysfunction may further be associated with poor functional outcome in patients' post-stroke. METHODS: In phase 1, a cross-sectional survey (n = 100) will be conducted to determine the prevalence of eye movement disorders and vestibular dysfunction in patients who sustained a stroke...
2016: Frontiers in Neurology
Simona Ferrante, Noelia Chia Bejarano, Emilia Ambrosini, Antonio Nardone, Anna M Turcato, Marco Monticone, Giancarlo Ferrigno, Alessandra Pedrocchi
It has been largely suggested in neuroscience literature that to generate a vast variety of movements, the Central Nervous System (CNS) recruits a reduced set of coordinated patterns of muscle activities, defined as muscle synergies. Recent neurophysiological studies have recommended the analysis of muscle synergies to finely assess the patient's impairment, to design personalized interventions based on the specific nature of the impairment, and to evaluate the treatment outcomes. In this scope, the aim of this study was to design a personalized multi-channel functional electrical stimulation (FES) controller for gait training, integrating three novel aspects: (1) the FES strategy was based on healthy muscle synergies in order to mimic the neural solutions adopted by the CNS to generate locomotion; (2) the FES strategy was personalized according to an initial locomotion assessment of the patient and was designed to specifically activate the impaired biomechanical functions; (3) the FES strategy was mapped accurately on the altered gait kinematics providing a maximal synchronization between patient's volitional gait and stimulation patterns...
2016: Frontiers in Neuroscience
H Sankaranarayan, Anupam Gupta, Meeka Khanna, Arun B Taly, K Thennarasu
OBJECTIVE: To study role of ankle foot orthosis (AFO) in improving locomotion and functional recovery after stroke. SETTING: Neurological Rehabilitation Department of a university research tertiary hospital. PATIENTS AND METHODS: AFO and activity based rehabilitation. MAIN OUTCOME MEASURES: Distance (meters) covered during the 6-minute walk test (6MWT) and speed (meter/second) during the 10-meter walk test. Functional abilities assessed using Functional Independence Measure (FIM(®))...
October 2016: Journal of Neurosciences in Rural Practice
Erika Pedreira da Fonseca, Nildo Manoel Ribeiro da Silva, Elen Beatriz Pinto
OBJECTIVES: The study aimed to check the therapeutic effect of virtual reality associated with conventional physiotherapy on gait balance and the occurrence of falls after a stroke. METHODS: This was a randomized, blinded clinical trial conducted with post-stroke patients, randomized into two groups-treatment group and control group-and subjected to balance assessments by the Dynamic Gait Index and investigation of falls before and after 20 intervention sessions...
September 29, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Woo-Sub Kim, Min Joo Kim
OBJECTIVE: Patients with post-stroke hemiplegia have difficulty with body weight support during walking. However, it is unclear which intra-limb strategy for body weight support tends to predominate, and how the intra-limb strategy is related to gait function. Support moment and individual joint contribution to support moment are the parameters that reflect intra-limb strategy for body weight supporting. The aim of this study was to test whether support moment and individual joint contributions differed between post-stroke subjects with different gait function...
August 12, 2016: Topics in Stroke Rehabilitation
George A Heckman, Alexander M Crizzle, Jonathen Chen, Tamara Pringsheim, Nathalie Jette, Marie-Jeanne Kergoat, Leslie Eckel, John P Hirdes
BACKGROUND: Patients with Parkinson's disease (PD) and/or Parkinsonism are affected by a complex burden of comorbidity. Many ultimately require institutional care, where they may be subject to the application of physical restraints or the prescription of antipsychotic medications, making them more vulnerable to adverse outcomes. OBJECTIVES: The objectives of this paper are to: 1) describe the clinical complexity of older institutionalized persons with PD; and 2) examine patterns and predictors of restraint use and prescription of antipsychotics in this population...
September 29, 2016: Journal of Parkinson's Disease
Gareth D Jones, Darren C James, Michael Thacker, David A Green
Individuals with sensorimotor pathology e.g., stroke have difficulty executing the common task of rising from sitting and initiating gait (sit-to-walk: STW). Thus, in clinical rehabilitation separation of sit-to-stand and gait initiation - termed sit-to-stand-and-walk (STSW) - is usual. However, a standardized STSW protocol with a clearly defined analytical approach suitable for pathological assessment has yet to be defined. Hence, a goal-orientated protocol is defined that is suitable for healthy and compromised individuals by requiring the rising phase to be initiated from 120% knee height with a wide base of support independent of lead limb...
2016: Journal of Visualized Experiments: JoVE
Thais Massetti, Tânia Brusque Crocetta, Talita Dias da Silva, Isabela Lopes Trevizan, Claudia Arab, Fátima Aparecida Caromano, Carlos Bandeira de Mello Monteiro
PURPOSE: To evaluate the methods and major outcomes of transcranial direct current stimulation (tDCS) combined with virtual reality (VR) therapy in randomized controlled trials. METHOD: A systematic review was performed following PRISMA guidelines using PubMed, PubMed Central, Web of Science and CAPES periodic databases, with no time restriction. The studies were screened for the following inclusion criteria: human subjects, combination of VR and tDCS methods, and randomized controlled study design...
September 27, 2016: Disability and Rehabilitation. Assistive Technology
David Chaparro, Justine Lacroix, Benoit Borel, Jean-Yves Salle, Benjamin Kammoun, Jean-Christophe Daviet, Stéphane Mandigout
OBJECTIVE: Physical activity (PA) and exercise are two successful approaches to reduce sedentary behavior and risk managing in stroke patients. The aims of the study are to evaluate PA and physical inactivity levels in post-stroke patients and to correlate PA parameters with gait performance, fatigue, anxiety, and anthropometry parameters in subacute phase of stroke recovery. MATERIAL/PATIENTS AND METHODS: Preliminary analysis of 24 patients in PA incitation program (mean age: 61...
September 2016: Annals of Physical and Rehabilitation Medicine
Jeanne Montastruc, David Amarantini, Valérie Lambert, Evelyne Castel-Lacanal, Philippe Marque, David Gasq
OBJECTIVE: Weight-bearing asymmetry (WBA) at the expense of the paretic side concerns 60% of stroke patients. WBA is associated with poor functional prognosis especially in terms of gait performance [1,2]. The primary objective was to assess the determinants of WBA in stroke patients from clinical and instrumental data. MATERIAL/PATIENTS AND METHODS: The sensitivity (EmNSA), motricity (Fugl-Meyer motor), spatial neglect and visual perception of verticality (VPV) were evaluated in 20 stroke patients (age: 53...
September 2016: Annals of Physical and Rehabilitation Medicine
Sébastien Baillieul, Dominic Perennou, Mathieu Marillier, Jean-Louis Pépin, Samuel Vergès, Bernard Wuyam
OBJECTIVE: Obstructive sleep apnea (OSA) is now widely seen as a major public health issue with widespread societal consequences. In addition to an increased stroke risk, OSA leads to cerebral consequences including cognitive deficits that impair quality of life and daily functioning. In a recent uncontrolled study, moderate-to-severe OSA have been associated with higher stride time variability (STV), reflecting poor gait control (Celle, Annweiler et al., 2014). STV is a clinical marker of cortical gait control linked with cognitive performance and cerebral integrity (Beauchet, Annweiler et al...
September 2016: Annals of Physical and Rehabilitation Medicine
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