Effects of Aerobic Treadmill Training on Gait Velocity, Cadence, and Gait Symmetry in Chronic Hemiparetic Stroke: A Preliminary Report

2000 ◽  
Vol 14 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Kenneth H.C. Silver ◽  
Richard F. Macko ◽  
Larry W. Forrester ◽  
Andrew P. Goldberg ◽  
Gerald V. Smith
Keyword(s):  
Ischemic Stroke ◽  
Functional Mobility ◽  
Treadmill Training ◽  
Assistive Device ◽  
Gait Velocity ◽  
Gait Symmetry ◽  
Before And After ◽  
Hemiparetic Stroke ◽  
Temporal Measures ◽  
Chronic Hemiparetic Stroke

It is widely assumed that only limited improvement in functional mobility is pos sible beyond the subacute period following ischemic stroke. Contrary to this notion, we studied "neurologically plateaued" stroke patients with chronic hemiparesis to as sess whether a "task-oriented" treadmill-training regimen would improve walking speed, cadence, and gait cycle symmetry on a modified "Get-Up and Go" task. Five male patients with a mean age of 60.4 ± 2.7 years (mean ± S.D.) status post ischemic stroke (> 6 months prior) participated in this nonrandomized low-intensity tread mill exercise pilot study three times/week for 3 months. All patients had mild to mod erate gait asymmetries due to residual hemiparesis. Patients were videotaped before and after 3 months of treadmill aerobic exercise (AEX) while performing a functional task consisting of arising from a chair, walking 3.1 m without an assistive device as fast as safely possible, and returning to sit. Gait events were timed using a 2-D Peak Motus™ video analysis system. After 3 months AEX training, times for the overall "get-up and return-to-sit" (GURS) task and the "straight-away walk" (SAW) segment decreased from 8.2 ± 1.4 sec to 6.5 ± 0.8 sec (mean ± SEM) (p < 0.05), and from 3.7 ± 1 sec to 2.8 ± 0.7 sec (p < 0.05), respectively. These data represent improve ments of 21% and 24% for the GURS and 'SAW segments, respectively. Mean veloc ity increased from 0.9 ± 0.2 to 1.2 ± 0.21 m/sec, a 33% improvement (p < 0.01). Mean cadence (steps/min) increased from 89 ± 9 to 97 ± 8, a 9% increase (p < 0.05). Mean stance and swing duration diminished for both paretic (P) and nonparetic (NP) limbs, and the intralimb stance/swing ratio values moved toward normal for both the paretic and nonparetic limbs. However, these latter changes reached significance only for the P limb. Interlimb stance symmetry was unchanged. The more impaired subjects experienced the greatest gains in gait velocity and temporal measures. Collectively, these findings indicate that treadmill exercise improves functional overground mo bility in individuals with chronic, stable hemiparesis. Key Words: Cerebrovascular disease—Hemiplegia—Exercise—Gait.

scholarly journals Immediate Effects of Kinesio Taping of Tibialis Anterior and Ankle Joint on Mobility and Balance Ability for Chronic Hemiparesis: Randomized Controlled Cross-Sectional Design

2020 ◽  
Vol 30 (06) ◽  
pp. 350-357
Author(s):  
Kyung-Hun Kim ◽  
Yang-Jin Lee
Keyword(s):  
Ankle Joint ◽  
Tibialis Anterior ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Kinesio Taping ◽  
Tibialis Muscle ◽  
Before And After ◽  
Balance Ability ◽  
Hemiparetic Stroke ◽  
Chronic Hemiparetic Stroke

Abstract Background Stroke patients with hemiparesis are generally described as being slow and suffering a balance disability. Objective The purpose of this cross-sectional single-blind study was to evaluate the immediate effects of Kinesio taping of tibialis anterior and quadriceps on the mobility and balance ability in individuals with chronic hemiparetic stroke. Methods Thirty-three subjects participated in this study. Participants were divided into 3 groups: Ankle Kinesio taping (AKT) group, a placebo (PKT) group, and a control (NKT) group. The AKT group underwent Kinesio tapping of ankle joint and tibialis muscle, PKT group underwent placebo taping, and NKT group underwent no Kinesio taping. All participants were assessed before and after taping training using timed up and go test (TUG), timed up and down stairs test (TUDS), and balance ability. Results After taping training, the AKT group showed significant improvement in mobility and balance ability compared to the PKT group and NKT group (p < 0.05). The results of this study confirmed that Kinesio taping was effective to the balance and mobility abilities of patients with chronic hemiparetic stroke. Conclusions This study suggested Kinesio taping as an effective intervention to increase the mobility and balance abilities of patients with chronic hemiparetic stroke. Therefore, this study are believed to provide the baseline information to effectively improve the balance and mobility abilities of patients with chronic hemiparetic stroke during the rehabilitation treatment in the future.

Hemiparetic Gait Parameters in Overground Versus Treadmill Walking

2001 ◽  
Vol 15 (2) ◽  
pp. 105-112 ◽  
Author(s):  
Michelle L. Harris-Love ◽  
Larry W. Forrester ◽  
Richard F. Macko ◽  
Kenneth H. C. Silver ◽  
Gerald V. Smith
Keyword(s):  
Gait Pattern ◽  
Supporting Evidence ◽  
Gait Symmetry ◽  
Paretic Limb ◽  
Hemiparetic Gait ◽  
Gait Parameters ◽  
Stance Time ◽  
Hemiparetic Stroke ◽  
Chronic Hemiparetic Stroke ◽  
Sparse Methods

Objective: Hemiparetic gait is characterized by high stride-cycle variability, di minished stance time, single-limb stance time, and stance/swing ratio in the paretic limb. Recent studies suggest treadmill (TM) training may improve the motor control underlying these variables, but supporting evidence is sparse. Methods: This study compared gait patterns of untrained chronic hemiparetic stroke patients (n = 18; mean, 39.5 months poststroke) during overground (OG) and TM walking at matched velocities. Variables included relative stance time, relative single-limb stance time, stance/swing ratio, peak force, and impulse. Within-subject variability of these meas ures (CV) was used to assess gait pattern stability. Results: OG and TM cycle dura tions were similar, but CVs differed (TM < OG, p < 0.05). In the paretic limb, dif ferences were seen in relative stance time, relative single-limb stance time, and stance/swing ratio, respectively (TM > OG, p < 0.05). These variables decreased in the nonparetic limb during TM walking (p < 0.05 for all). Improved interlimb sym metry and coordination were evidenced by decreased between-limb differences and improved relative temporal phasing, respectively, in the TM condition (p < 0.05). Conclusions: Collectively, these results demonstrate that the TM induces an imme diate alteration toward a more consistent and symmetric gait pattern. Further inves tigation is needed to determine whether TM training leads to motor relearning and neuroplasticity in chronic hemiparetic subjects. Key Words: Stroke—Rehabilitation— Hemiparetic gait-Treadmill-Gait symmetry.

scholarly journals Motor Impairment–Related Alterations in Biceps and Triceps Brachii Fascicle Lengths in Chronic Hemiparetic Stroke

2018 ◽  
Vol 32 (9) ◽  
pp. 799-809 ◽  
Author(s):  
Christa M. Nelson ◽  
Wendy M. Murray ◽  
Julius P. A. Dewald
Keyword(s):  
Motor Impairment ◽  
Distal Portion ◽  
Functional Mobility ◽  
Triceps Brachii ◽  
Motor Impairments ◽  
Fascicle Length ◽  
Paretic Limb ◽  
Hemiparetic Stroke ◽  
Long Head ◽  
Chronic Hemiparetic Stroke

Poststroke deficits in upper extremity function occur during activities of daily living due to motor impairments of the paretic arm, including weakness and abnormal synergies, both of which result in altered use of the paretic arm. Over time, chronic disuse and a resultant flexed elbow posture may result in secondary changes in the musculoskeletal system that may limit use of the arm and impact functional mobility. This study utilized extended field-of-view ultrasound to measure fascicle lengths of the biceps (long head) and triceps (distal portion of the lateral head) brachii in order to investigate secondary alterations in muscles of the paretic elbow. Data were collected from both arms in 11 individuals with chronic hemiparetic stroke, with moderate to severe impairment as classified by the Fugl-Meyer assessment score. Across all participants, significantly shorter fascicles were observed in both biceps and triceps brachii ( P < .0005) in the paretic limb under passive conditions. The shortening in paretic fascicle length relative to the nonparetic arm measured under passive conditions remained observable during active muscle contraction for the biceps but not for the triceps brachii. Finally, average fascicle length differences between arms were significantly correlated to impairment level, with more severely impaired participants showing greater shortening of paretic biceps fascicle length relative to changes seen in the triceps across all elbow positions ( r = −0.82, P = .002). Characterization of this secondary adaptation is necessary to facilitate development of interventions designed to reduce or prevent the shortening from occurring in the acute stages of recovery poststroke.

scholarly journals Treatment with Delipid Extracorporeal Lipoprotein Filter from Plasma after Intravenous Thrombolysis for Acute Ischemic Stroke: A Single-Center Experience

2020 ◽  
Vol 10 (3) ◽  
pp. 148-158
Author(s):  
Yu Cui ◽  
Zhong-He Zhou ◽  
Xiao-Wen Hou ◽  
Hui-Sheng Chen
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Intravenous Thrombolysis ◽  
Single Center Experience ◽  
Before And After ◽  
Prospective Trials ◽  
Symptomatic Intracranial Hemorrhage ◽  
Rate Of Improvement

<b><i>Introduction:</i></b> The delipid extracorporeal lipoprotein filter from plasma (DELP) has been approved for the treatment of acute ischemic stroke (AIS) by the China Food and Drug Administration, but its effectiveness and mechanism are not yet fully determined. The purpose of this study was to evaluate the effect of DELP treatment on AIS patients after intravenous thrombolysis. <b><i>Methods:</i></b> A retrospective study was performed on AIS patients with no improvement within 24 h after intravenous thrombolysis who were subsequently treated with or without DELP. Primary outcome was the proportion with a modified Rankin scale (mRS) of 0–1 at 90 days. Secondary outcomes were changes in National Institute of Health Stroke Scale (NIHSS) score from 24 h to 14 days after thrombolysis, and the rate of improvement in stroke-associated pneumonia (SAP). The main safety outcomes were the rates of symptomatic intracranial hemorrhage and mortality. To investigate its mechanisms, serum biomarkers were measured before and after DELP. <b><i>Results:</i></b> A total of 252 patients were recruited, 63 in the DELP group and 189 matched patients in the NO DELP group. Compared with the NO DELP group, the DELP group showed an increase in the proportion of mRS 0–1 at 90 days (<i>p</i> = 0.042). More decrease in NIHSS from 24 h to 14 days (<i>p</i> = 0.024), a higher rate of improvement in SAP (<i>p</i> = 0.022), and lower mortality (<i>p</i> = 0.040) were shown in DELP group. Furthermore, DELP decreased levels of interleukin (IL)-1β, E-selectin, malondialdehyde, matrix metalloprotein 9, total cholesterol, low-density lipoprotein, and fibrinogen, and increased superoxide dismutase (<i>p</i>&#x3c; 0.05). <b><i>Conclusions:</i></b> DELP following intravenous thrombolysis should be safe, and is associated with neurological function improvement, possibly through multiple neuroprotective mechanisms. Prospective trials are needed.

scholarly journals Effects of Dynamic Elastomeric Fabric Orthoses on Children with Cerebral Palsy

2009 ◽  
Vol 33 (4) ◽  
pp. 339-347 ◽  
Author(s):  
Martin John Matthews ◽  
Martin Watson ◽  
Barbara Richardson
Keyword(s):  
Cerebral Palsy ◽  
Single Case ◽  
Phase 1 ◽  
Functional Mobility ◽  
Gait Velocity ◽  
Controlled Study ◽  
Patient Specific ◽  
Spastic Diplegia ◽  
Cost Index ◽  
Beneficial Effects

This phase 1 exploratory study aimed to establish proof of concept of the effects of dynamic elastomeric fabric orthoses (DEFOs) on the gait of children with spastic diplegic cerebral palsy. Replicated single case experiments employing an ABA methodology were carried out on eight subjects (median age 5.5 years, range 3–13 years; 4 girls/boys) utilizing quantitative/qualitative data collection. Outcome measures were: Ten metre walking test (10MWT); physiological cost index (PCI); visual analogue scale (VAS) scoring of perceived gait changes; functional mobility changes using Patient Specific Functional Scale (PSFS); subject/carer perceptions recorded in daily diaries. Results identified following analysis of quantitative data indicated a treatment effect from the orthoses which could be corroborated by participant subjective impressions and comments. Statistically significant ( p < 0.05) intervention-related improvements in gait velocity and gait consistency were identified respectively in 5/8 and 4/8 subjects. Power calculations support the feasibility of a larger controlled study to further investigate this orthotic intervention. This study indicates that DEFO leggings can confer beneficial effects on the gait of some children with spastic diplegia resulting from CP. These findings have implications for orthotic intervention with this subject group.

The NIH Stroke Scale Lacks Validity in Chronic Hemiparetic Stroke

2015 ◽  
Vol 96 (10) ◽  
pp. e35
Author(s):  
Heather Tanksley Peters ◽  
Susan White ◽  
Stephen Page
Keyword(s):  
Hemiparetic Stroke ◽  
Chronic Hemiparetic Stroke
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