Mediolateral foot placement ability during ambulation in individuals with chronic post-stroke hemiplegia

Background: Accurate and precise mediolateral foot placement is important for balance during gait, but is impaired post stroke. Mediolateral foot placement may be improved with ankle–foot orthosis use. Objective: The purpose of this study was to determine whether an ankle–foot orthosis improves mediolateral foot-placement ability during post-stroke ambulation. Study design: Crossover trial with randomized order of conditions tested. Methods: The accuracy and precision of mediolateral foot placement was quantified while subjects targeted four different randomized step widths. Subjects were tested with and without their regular non-rigid ankle–foot orthosis in two separate visits (order randomized). Results: While ankle–foot orthosis use corrected foot and ankle alignment (i.e. significantly decreased mid-swing plantar flexion, p = 0.000), effects of ankle–foot orthosis use on hip hiking ( p = 0.545), circumduction ( p = 0.179), coronal plane hip range of motion ( p = 0.06), and mediolateral foot-placement ability ( p = 0.537) were not significant. Conclusion: While ankle–foot orthosis–mediated equinovarus correction of the affected foot and ankle was not associated with improved biomechanics of walking (i.e. proximal ipsilateral hip kinematics or mediolateral foot-placement ability), it may affect other aspects of balance that were not tested in this study (e.g. proprioception, cerebellar, vestibular, and cognitive mechanisms). Clinical relevance Studies that investigate the effect of ankle–foot orthosis on gait can help advance stroke rehabilitation by documenting the specific gait benefits of ankle–foot orthosis use. In this study, we investigated the effect of ankle–foot orthosis use on mediolateral foot-placement ability, an aspect of gait important for maintaining balance.

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Sensory electrical stimulation improves foot placement during targeted stepping post-stroke

Experimental Brain Research ◽

10.1007/s00221-014-3823-2 ◽

2014 ◽

Vol 232 (4) ◽

pp. 1137-1143 ◽

Cited By ~ 12

Author(s):

Eric R. Walker ◽

Allison S. Hyngstrom ◽

Brian D. Schmit

Keyword(s):

Electrical Stimulation ◽

Foot Placement ◽

Post Stroke

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Comparison of Partial Body Weight-Supported Treadmill Gait Training Versus Aggressive Bracing Assisted Walking Post Stroke

Neurorehabilitation and Neural Repair ◽

10.1177/154596830001400102 ◽

2000 ◽

Vol 14 (1) ◽

pp. 13-19 ◽

Cited By ~ 119

Author(s):

Marc C. Kosak ◽

Michael J. Reding

Keyword(s):

Body Weight ◽

Gait Training ◽

Foot Placement ◽

Hemispheric Stroke ◽

Post Stroke ◽

Training Techniques ◽

Leg Weakness ◽

Partial Body ◽

To Receive ◽

Minute Session

Purpose: To test the hypothesis that partial body weight-supportcd treadmill training (PBWSTT) provides more effective gait training than an equally supportive but less physiologic aggressive bracing assisted walking (ABAW) program. Methods: Following informed consent, patients participating in an inpatient re habilitation program with significant leg weakness and need for at least moderate as sistance for walking, without orthostatic hypotension, symptomatic dyspnea, or angina pectoris were randomized to receive PBWSTT vs. ABAW. PBWSTT was provided by a commercially available, overhead motorized hoist attached to a parachute-type body harness, which provided partial support of the patient's weight over a treadmill. Ther apists assisted with weight shifting, leg advancement, and foot placement as needed. ABAW included aggressive early therapist-assisted ambulation using knee-ankle com bination bracing and hemi-bar if needed. Treatment sessions of up to 45 minutes per day, five days per week were given as tolerated for the duration of the inpatient stay or until patients could walk over-ground unassisted. All patients had an additional 45- minute session of functionally oriented physical therapy each day with or without brac ing as judged appropriate by the patient's individual therapist. Results: Fifty-six patients a mean age of 71 ±1 SEM were enrolled 40 ± 3 days post stroke. Although die outcome of the two groups as a whole did not differ, a subgroup with major hemispheric stroke defined by the presence of hemiparesis, hemianopic vi sual deficit, and hemihypesthesia who received more than 12 treatment sessions showed significantly better over-ground endurance (90 ± 34 vs. 44 ± 10 meters) and speed scores (12 ± 4 vs. 8 ± 2 meters/minute) for PBWSTT vs. ABAW, respectively. Conclusions: PBWSTT and ABAW are equally effective gait training techniques except for a subset of patients with major hemispheric stroke who are difficult to mo bilize using ABAW alone.

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Post-stroke deficits in mediolateral foot placement accuracy depend on the prescribed walking task

Journal of Biomechanics ◽

10.1016/j.jbiomech.2021.110738 ◽

2021 ◽

Vol 128 ◽

pp. 110738

Author(s):

Katy H. Stimpson ◽

Aaron E. Embry ◽

Jesse C. Dean

Keyword(s):

Foot Placement ◽

Post Stroke ◽

Placement Accuracy

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Brain Imaging Could Predict Aphasia Post-Stroke

ASHA Leader ◽

10.1044/leader.rib2.21102016.14 ◽

2016 ◽

Vol 21 (10) ◽

pp. 14-14

Keyword(s):

Brain Imaging ◽

Post Stroke

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Intensive Treatment May Improve Verbal Communication in Patients with Post-Stroke Chronic Aphasia

ASHA Leader ◽

10.1044/leader.rib2.22112017.15 ◽

2017 ◽

Vol 22 (11) ◽

pp. 15-15 ◽

Cited By ~ 1

Keyword(s):

Verbal Communication ◽

Intensive Treatment ◽

Post Stroke ◽

Chronic Aphasia

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Transcranial Electrical Stimulation in Post-Stroke Cognitive Rehabilitation

European Psychologist ◽

10.1027/1016-9040/a000238 ◽

2016 ◽

Vol 21 (1) ◽

pp. 55-64 ◽

Cited By ~ 4

Author(s):

Silvia Convento ◽

Cristina Russo ◽

Luca Zigiotto ◽

Nadia Bolognini

Keyword(s):

Electrical Stimulation ◽

Cognitive Rehabilitation ◽

Cognitive Disorders ◽

Spatial Neglect ◽

Transcranial Electrical Stimulation ◽

Clinical Settings ◽

Post Stroke ◽

Neuropsychological Disorders ◽

Current State ◽

Stimulation Technique

Abstract. Cognitive rehabilitation is an important area of neurological rehabilitation, which aims at the treatment of cognitive disorders due to acquired brain damage of different etiology, including stroke. Although the importance of cognitive rehabilitation for stroke survivors is well recognized, available cognitive treatments for neuropsychological disorders, such as spatial neglect, hemianopia, apraxia, and working memory, are overall still unsatisfactory. The growing body of evidence supporting the potential of the transcranial Electrical Stimulation (tES) as tool for interacting with neuroplasticity in the human brain, in turn for enhancing perceptual and cognitive functions, has obvious implications for the translation of this noninvasive brain stimulation technique into clinical settings, in particular for the development of tES as adjuvant tool for cognitive rehabilitation. The present review aims at presenting the current state of art concerning the use of tES for the improvement of post-stroke visual and cognitive deficits (except for aphasia and memory disorders), showing the therapeutic promises of this technique and offering some suggestions for the design of future clinical trials. Although this line of research is still in infancy, as compared to the progresses made in the last years in other neurorehabilitation domains, current findings appear very encouraging, supporting the development of tES for the treatment of post-stroke cognitive impairments.

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