scholarly journals The immediate effects of a novel auditory and proprioceptive training device on gait after stroke

2011 ◽  
Vol 1 (3) ◽  
pp. 46
Author(s):  
Eric G. Johnson ◽  
Everett B. Lohman ◽  
Abel Rendon ◽  
Ektaben G. Dobariya ◽  
Shubhada S. Ramani ◽  
...  

<p>This case report describes the immediate effects of a new rehabilitation tool on gait in a chronic stroke patient. Specifically, we measured step length symmetry and gait velocity in a 47 year-old male stroke patient who was currently receiving outpatient physical therapy. Objective gait measurements were taken using the GAITRite before, during, and after a 5 minute training session. Step length symmetry improved 26% during the first minute of<sup> </sup>training, 71% by the fifth minute of training, and 72% after a 5 minute rest period post-training. Gait velocity increased by 5.5% after 5 minutes of training. Clinical research is warranted to validate this new training tool as a useful adjunctive rehabilitation activity for improving spatial and temporal aspects of gait after stroke. <strong></strong></p>

2021 ◽  
Vol 11 (4) ◽  
pp. 500
Author(s):  
Geetanjali Gera ◽  
Zain Guduru ◽  
Tritia Yamasaki ◽  
Julie A. Gurwell ◽  
Monica J. Chau ◽  
...  

Background: The efficacy of deep brain stimulation (DBS) and dopaminergic therapy is known to decrease over time. Hence, a new investigational approach combines implanting autologous injury-activated peripheral nerve grafts (APNG) at the time of bilateral DBS surgery to the globus pallidus interna. Objectives: In a study where APNG was unilaterally implanted into the substantia nigra, we explored the effects on clinical gait and balance assessments over two years in 14 individuals with Parkinson’s disease. Methods: Computerized gait and balance evaluations were performed without medication, and stimulation was in the off state for at least 12 h to best assess the role of APNG implantation alone. We hypothesized that APNG might improve gait and balance deficits associated with PD. Results: While people with a degenerative movement disorder typically worsen with time, none of the gait parameters significantly changed across visits in this 24 month study. The postural stability item in the UPDRS did not worsen from baseline to the 24-month follow-up. However, we measured gait and balance improvements in the two most affected individuals, who had moderate PD. In these two individuals, we observed an increase in gait velocity and step length that persisted over 6 and 24 months. Conclusions: Participants did not show worsening of gait and balance performance in the off therapy state two years after surgery, while the two most severely affected participants showed improved performance. Further studies may better address the long-term maintanenace of these results.


2021 ◽  
Vol 99 (Supplement_3) ◽  
pp. 92-92
Author(s):  
Jennie L Ivey ◽  
Lew G Strickland ◽  
Justin D Rhinehart

Abstract Developing livestock and equine trainings to empower county Extension agents is challenging, especially when spanning in-person and online delivery modules. Real life application of training concepts is difficult, particularly when participants have varied backgrounds and experience. Thus, we assessed if scenario-based training modules were an effective training method across in-person and virtual formats. The same scenario-based training was delivered at three, regional in-person trainings (n = 42), and one virtual training (n = 32). Training format consisted of four, species-specific lectures addressing various production topics. Small groups then developed recommendations for a specific scenario, followed by a debriefing session consisting of group reactions and specialist recommendations. Topic-area application to county programs, instructor effectiveness, and overall benefit of the training session were evaluated (Qualtrics, in-person n = 26, 62% completion; virtual n = 17, 53% completion). Data were assessed using analysis of variance and mean comparisons (α=0.05), with Tukey’s pairwise post hoc analysis where appropriate (STATA 16). Across all sessions, likert scale responses (1=poor and 5=excellent, n = 43) indicated lecture sessions were applicable to county areas of need across material content (mean±SD, cattle=4.71±0.57, equine=4.64±0.50), teaching effectiveness (cattle=4.77±0.42, equine=4.75±0.43), and overall quality (cattle=4.68±0.57, equine=4.67±0.51), respectively. Scenario-based training benefit was not influenced by the number of times an agent had attended in-service training on livestock species, agent appointment (youth vs. adult educator), or training location (p &gt;0.05). Attendance at previous in-service trainings (cattle P = 0.005; equine P = 0.013) and agent appointment (cattle P = 0.0006; equine P = 0.05) had a significant impact on the number of questions agents reported to have received on scenario topics in the last 12 months. More topic area questions were reported by agents with adult education responsibilities and previous training attendance. Based upon these results, scenario-based training is an effective in-person and virtual training tool for 4-H and adult Extension agents of varying experience.


2015 ◽  
Vol 21 (4) ◽  
pp. 413-416 ◽  
Author(s):  
Manon Herfurth ◽  
Jana Godau ◽  
Barbara Kattner ◽  
Silvia Rombach ◽  
Stefan Grau ◽  
...  

2021 ◽  
Author(s):  
IlHyun Son ◽  
GyuChang Lee

Abstract Background: It has been reported the effects of a hinged ankle-foot orthosis on the gait ability of children with cerebral palsy. However, no studies investigated the effects of the dorsiflexion angle of the hinged ankle-foot orthosis on the spatiotemporal gait parameters of children with cerebral palsy. This study aimed to investigate the immediate effects of a 10° dorsiflexion inducing ankle-foot orthosis the spatiotemporal gait parameters of children with spastic diplegia compared to barefoot and a hinged ankle-foot orthosis.Methods: This study was cross-over design. 10 children with spastic diplegia were walked with barefoot, a hinged ankle-foot orthosis, and a 10° dorsiflexion inducing ankle-foot orthosis. GAITRite was used to collect the spatiotemporal gait parameters including gait velocity, cadence, step length, stride length, single leg support, and double leg support. Results: It showed that a 10° dorsiflexion inducing ankle-foot orthosis significantly improved the gait velocity, cadence, step length, stride length, single leg support, and double leg support than barefoot and a hinged ankle-foot orthosis (p<.05). Conclusion: The results of this study implied that a 10° dorsiflexion inducing ankle-foot orthosis could improve the gait ability of children with spastic diplegia more than barefoot or a hinged ankle-foot orthosis. High quality future studies will need to examine the effects of hinged ankle-foot orthosis on gait ability according to dorsiflexion angles.


2020 ◽  
Author(s):  
Toby J Ellmers ◽  
Elmar C Kal ◽  
James K Richardson ◽  
William R Young

Abstract Background Overly cautious gait is common in older adults. This is characterised by excessively slow gait, shortened steps, broadened base of support and increased double limb support. The current study sought to (1) evaluate if overly cautious gait is associated with attempts to consciously process walking movements, and (2) explore whether an individual’s ability to rapidly inhibit a dominant motor response serves to mitigate this relationship. Methods A total of 50 older adults walked at a self-selected pace on an instrumented walkway containing two raised wooden obstacles (height = 23 cm). Trait conscious movement processing was measured with the Movement-Specific Reinvestment Scale. Short-latency inhibitory function was assessed using a validated electronic go/no-go ruler catch protocol. We used linear regressions to explore the relationship between these variables and gait parameters indicative of overly cautious gait. Results When controlling for general cognitive function (MoCA), and functional balance (Berg Balance Scale), the interaction between trait conscious movement processing and short-latency inhibition capacity significantly predicted gait velocity, step length and double limb support. Specifically, older adults with higher trait conscious movement processing and poorer inhibition were more likely to exhibit gait characteristics indicative of cautious gait (i.e. reduced velocity, shorter step lengths and increased double limb support). Neither conscious movement processing nor inhibition independently predicted gait performance. Conclusion The combination of excessive movement processing tendencies and poor short-latency inhibitory capacity was associated with dysfunctional or ‘overly cautious’ gait. It is therefore plausible that improvement in either factor may lead to improved gait and reduced fall risk.


2017 ◽  
Vol 5 (2) ◽  
pp. 291-303
Author(s):  
Maxime Trempe ◽  
Jean-Luc Gohier ◽  
Mathieu Charbonneau ◽  
Jonathan Tremblay

In recent years, it has been shown that spacing training sessions by several hours allows the consolidation of motor skills in the brain, a process leading to the stabilization of the skills and, sometimes, further improvement without additional practice. At the moment, it is unknown whether consolidation can lead to an improvement in performance when the learner performs complex full-body movements. To explore this question, we recruited 10 divers and had them practice a challenging diving maneuver. Divers first performed an initial training session, consisting of 12 dives during which visual feedback was provided immediately after each dive through video replay. Two retention tests without feedback were performed 30 min and 24 hr after the initial training session. All dives were recorded using a video camera and the participants’ performance was assessed by measuring the verticality of the body segments at water entry. Significant performance gains were observed in the 24-hr retention test (p < .05). These results suggest that the learning of complex full-body movements can benefit from consolidation and that splitting practice sessions can be used as a training tool to facilitate skill acquisition.


2019 ◽  
Vol 122 (4) ◽  
pp. 1598-1605 ◽  
Author(s):  
Jaimie A. Roper ◽  
Sarah A. Brinkerhoff ◽  
Benjamin R. Harrison ◽  
Abigail C. Schmitt ◽  
Ryan T. Roemmich ◽  
...  

Essential tremor (ET) is a common movement disorder that causes motor deficits similar to those seen in cerebellar disorders. These include kinetic tremor, gait ataxia, and impaired motor adaptation. Previous studies of motor adaptation in ET have focused on reaching while the effects of ET on gait adaptation are currently unknown. The purpose of this study was to contrast locomotor adaptation in persons with and without ET. We hypothesized that persons with ET would show impaired gait adaptation. In a cross-sectional study, persons with ET ( n = 14) and healthy matched controls ( n = 12) walked on a split-belt treadmill. Participants walked with the belts moving at a 2:1 ratio, followed by overground walking to test transfer, followed by a readaptation period and finally a deadaptation period. Step length asymmetry was measured to assess the rate of adaptation, amount of transfer, and rates of readaptation and deadaptation. Spatial, temporal, and velocity contributions to step length asymmetry were analyzed during adaptation. There were no group by condition interactions in step length asymmetry or contributions to step length asymmetry. Regardless of condition, persons with ET walked slower and exhibited lower temporal ( P < 0.001) and velocity ( P = 0.001) contributions to step length asymmetry than controls. Persons with ET demonstrated a preserved ability to adapt to, store, and transfer a new walking pattern. Despite probable cerebellar involvement in ET, locomotor adaptation is an available mechanism to teach persons with ET new gait patterns. NEW & NOTEWORTHY This study is the first to investigate walking adaptation abilities of people with essential tremor. Despite evidence of cerebellar impairment in this population, people with essential tremor can adapt their walking patterns. However, people with essential tremor do not modulate the timing of their footsteps to meet walking demands. Therefore, this study is the first to report impairments in the temporal aspects of walking in people with essential tremor during both typical and locomotor learning.


2020 ◽  
Vol 10 (12) ◽  
pp. 978
Author(s):  
Hanatsu Nagano ◽  
Catherine M. Said ◽  
Lisa James ◽  
Rezaul K. Begg

Hemiplegic stroke often impairs gait and increases falls risk during rehabilitation. Tripping is the leading cause of falls, but the risk can be reduced by increasing vertical swing foot clearance, particularly at the mid-swing phase event, minimum foot clearance (MFC). Based on previous reports, real-time biofeedback training may increase MFC. Six post-stroke individuals undertook eight biofeedback training sessions over a month, in which an infrared marker attached to the front part of the shoe was tracked in real-time, showing vertical swing foot motion on a monitor installed in front of the subject during treadmill walking. A target increased MFC range was determined, and participants were instructed to control their MFC within the safe range. Gait assessment was conducted three times: Baseline, Post-training and one month from the final biofeedback training session. In addition to MFC, step length, step width, double support time and foot contact angle were measured. After biofeedback training, increased MFC with a trend of reduced step-to-step variability was observed. Correlation analysis revealed that MFC height of the unaffected limb had interlinks with step length and ankle angle. In contrast, for the affected limb, step width variability and MFC height were positively correlated. The current pilot-study suggested that biofeedback gait training may reduce tripping falls for post-stroke individuals.


2016 ◽  
Vol 15 (6) ◽  
pp. 805-814 ◽  
Author(s):  
Anjali Sehrawat ◽  
Robert Keelan ◽  
Kenji Shimada ◽  
Dona M. Wilfong ◽  
James T. McCormick ◽  
...  

A proof-of-concept for an advanced-level computerized training tool for cryosurgery is demonstrated, based on three-dimensional cryosurgery simulations and a variable insertion depth strategy for cryoprobes. The objective for system development is two-fold: to identify a cryoprobe layout in order to best match a planning isotherm with the target region shape and to verify that cryoprobe placement does not violate accepted geometric constraints. System validation has been performed by collecting training data from 17 surgical residents having no prior experience or advanced knowledge of cryosurgery. This advanced-level study includes an improved training session design in order to enhance knowledge dissemination and elevate participant motivation to excel. In terms of match between a planning isotherm and the target region shape, results of this demonstrate trainee performance improvement from 4.4% in a pretest to 44.4% in a posttest over a course of 50 minutes of training. In terms of combined performance, including the above-mentioned geometrical match and constraints on cryoprobe placement, this study demonstrates trainee performance improvement from 2.2% in the pretest to 31.1% in the posttest. Given the relatively short training session and the lack of prior knowledge, these improvements are significant and encouraging. These results are of particular significance, as they have been obtained from a surgical resident population which are exposed to the typical stress and constraints in advanced surgical education.


2014 ◽  
Vol 95 (10) ◽  
pp. e31-e32
Author(s):  
Vincent DePaul ◽  
Kara Kathleen Patterson ◽  
Elizabeth L. Inness ◽  
Avril Mansfield ◽  
George Mochizuki ◽  
...  
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