gait training
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PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261732
Author(s):  
Prabhat Pathak ◽  
Jeongin Moon ◽  
Se-gon Roh ◽  
Changhyun Roh ◽  
Youngbo Shim ◽  
...  

Minimum toe clearance (MTC) is an important indicator of the risk of tripping. Aging and neuromuscular diseases often decrease MTC height and increase its variability, leading to a higher risk of tripping. Previous studies have developed visual feedback-based gait training systems to modify MTC. However, these systems are bulky and expensive, and the effects of the training continue only for a short time. We paid attention to the efficacy of vibration in decreasing the variability of gait parameters, and hypothesized that proper vibration applied to soles can reduce the MTC variability. Using shoes embedded with active vibrating insoles, we assessed the efficacy of both sub- and supra-threshold vibration in affecting MTC distribution. Experiment results with 17 young and healthy adults showed that vibration applied throughout the walking task with constant intensity of 130% of sensory threshold significantly decreased MTC variability, whereas sub-threshold vibration yielded no significant effect. These results demonstrate that a properly designed tactile sensory input which is controlled and delivered by a simple wearable device, the active insole, can reduce the MTC variability during walking.


2022 ◽  
Vol 91 ◽  
pp. 79-85
Author(s):  
Yongshi Wang ◽  
Lei Gao ◽  
Hongjiao Yan ◽  
Zhaohui Jin ◽  
Jinping Fang ◽  
...  

Author(s):  
Patcharee Kooncumchoo ◽  
Phuwarin Namdaeng ◽  
Somrudee Hanmanop ◽  
Bunyong Rungroungdouyboon ◽  
Kultida Klarod ◽  
...  

Chronic stroke leads to the impairment of lower limb function and gait performance. After in-hospital rehabilitation, most individuals lack continuous gait training because of the limited number of physical therapists. This study aimed to evaluate the effects of a newly invented gait training machine (I-Walk) on lower limb function and gait performance in chronic stroke individuals. Thirty community-dwelling chronic stroke individuals were allocated to the I-Walk machine group (n = 15) or the overground gait training (control) group (n = 15). Both groups received 30 min of upper limb and hand movement and sit-to-stand training. After that, the I-Walk group received 30 min of I-Walk training, while the control followed a 30-minute overground training program. All the individuals were trained 3 days/week for 8 weeks. The primary outcome of the motor recovery of lower limb impairment was measured using the Fugl–Meyer Assessment (FMA). The secondary outcomes for gait performance were the 6-minute walk test (6 MWT), the 10-meter walk test (10 MWT), and the Timed Up and Go (TUG). The two-way mixed-model ANOVA with the Bonferroni test was used to compare means within and between groups. The post-intervention motor and sensory subscales of the FMA significantly increased compared to the baseline in both groups. Moreover, the 6 MWT and 10 MWT values also improved in both groups. In addition, the mean difference of TUG in the I-Walk was higher than the control. The efficiency of I-Walk training was comparable to overground training and might be applied for chronic stroke gait training in the community.


2021 ◽  
Vol 12 ◽  
Author(s):  
Faustyna Manikowska ◽  
Sabina Brazevic ◽  
Anna Krzyżańska ◽  
Marek Jóźwiak

Background: Gait dysfunction is a crucial factor that restricts independence and quality of life in children with cerebral palsy (CP). Gait training based on robotic-assisted therapy (RAT) is widely used, but information about effectiveness and ideal patient profile is not sufficient. Aim of this study was to assess the effect of RAT on gait parameters in spastic children with CP, and to determine whether changes in gait parameters are different among patients on different ambulatory levels.Method: A total of 26 children with bilateral spastic CP were divided into two groups based on their functional ability: non-assisted ambulator (NAS) or assisted ambulator (AS); and underwent a RAT program (30 training sessions of RAT during 10 weeks). Gait analysis was performed: before the therapy (t1), right after (t2), and 6 weeks later (t3).Results: No significant changes in spatiotemporal parameters or gait deviation index at t2 or t3. Double support symmetry significantly improved (t1 vs. t3, p = 0.03) for the whole group (NAS + AS). Walking speed symmetry significantly improved (t2 vs. t3, p = 0.02) for group AS.Conclusion: RAT based on our protocol did not change spatiotemporal parameters and kinematics of walking except limited improvement in some aspects of gait symmetry. We did not find differences in changes in selected objective gait parameters among children with CP in different ambulatory levels.


2021 ◽  
Vol 10 (6) ◽  
pp. 3751-3753
Author(s):  
Sakshi Kariya

According to a systemic analysis conducted in 2017, the blunt stroke incidence in various parts of India ranged from 44.29 to 559 per 100,000 people over the previous two decades. Stroke is the sudden loss of any neurological function due to a disturbance of blood flow. The majority of stroke victims suffer from long-term disability. We present the case of a 72-year-old woman who was admitted to the hospital with symptoms of fatigue on the left side of her body and facial palsy on the left side, on further assessment it was found that patient had coronary artery bypass grafting before 10 years with no post-operative complications and also had a history of hypothyroidism, this brings about the suspicion about the correlation between the stroke with the history of IHD and hypothyroidism. To manage these passive movements breathing exercises, bed mobility exercises, strengthening exercises followed by gait training was given which was highly effective to make the patient independent and return to her daily activities


Author(s):  
Arpita Shetty ◽  
K. M. Krishnaprasad

Progressive supranuclear palsy (PSP) is a rare neurodegenerative disease which mimic similar to Parkinsonism. PSP advances much quicker than in PD yet no effective medication or therapy to manage PSP available. This literature review aimed to discover the recent advances in the physical therapy treatment options for PSP. Databases such as PubMed, Elsevier and SAGE journal searched for both published and unpublished studies. Last 10-year studies were included in this review. Limited clinical trial conducted in this population due to which a structured protocol or rehabilitation strategies is missing for this condition. Balance exercise and gait training showed potential benefit and music-cued walking demonstrated participant’s satisfaction.


2021 ◽  
Vol 15 ◽  
Author(s):  
Tsubasa Mitsutake ◽  
Takeshi Imura ◽  
Tomonari Hori ◽  
Maiko Sakamoto ◽  
Ryo Tanaka

Objective: Combining transcranial direct current stimulation (tDCS) and repetitive gait training may be effective for gait performance recovery after stroke; however, the timing of stimulation to obtain the best outcomes remains unclear. We performed a systematic review and meta-analysis to establish evidence for changes in gait performance between online stimulation (tDCS and repetitive gait training simultaneously) and offline stimulation (gait training after tDCS).Methods: We comprehensively searched the electronic databases Medline, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database, and Cumulative Index to Nursing and Allied Health Literature, and included studies that combined cases of anodal tDCS with motor-related areas of the lower limbs and gait training. Nine studies fulfilled the inclusion criteria and were included in the systematic review, of which six were included in the meta-analysis.Result: The pooled effect estimate showed that anodal tDCS significantly improved the 10-m walking test (p = 0.04; I2 = 0%) and 6-min walking test (p = 0.001; I2 = 0%) in online stimulation compared to sham tDCS.Conclusion: Our findings suggested that simultaneous interventions may effectively improve walking ability. However, we cannot draw definitive conclusions because of the small sample size. More high-quality studies are needed on the effects of online stimulation, including various stimulation parameters.


2021 ◽  
Vol 10 (23) ◽  
pp. 5715
Author(s):  
Wonjun Oh ◽  
Chanhee Park ◽  
Seungjun Oh ◽  
Sung (Joshua) H. You

We aimed to compare the effects of robotic-assisted gait training (RAGT) in patients with FAC < 2 (low initial functional ambulation category [LFAC]) and FAC ≥ 2 (high initial functional ambulation category [HFAC]) on sensorimotor and spasticity, balance and trunk stability, the number of steps and walking distance in subacute hemiparetic stroke. Fifty-seven patients with subacute hemiparetic stroke (mean age, 63.86 ± 12.72 years; 23 women) were assigned to two groups. All patients received a 30-min Walkbot-assisted gait training session, 3 times/week, for 6 weeks. Clinical outcomes included scores obtained on the Fugl–Meyer Assessment (FMA) scale, Modified Ashworth Scale (MAS), Berg Balance Scale (BBS), trunk impairment scale (TIS), and the number of walking steps and walking distance. Analysis of covariance and analysis of variance were conducted at p < 0.05. Significant main effects of time in both groups on number of walking steps and distance (p < 0.05) were observed, but not in MAS (p> 0.05). Significant changes in FMA, BBS, and TIS scores between groups (p < 0.05) were observed. Significant main effects of time on BBS and TIS were demonstrated (p < 0.05). Our study shows that RAGT can maximize improvement in the functional score of FMA, BBS, TIS, steps, and distance during neurorehabilitation of subacute stroke patients regardless of their FAC level.


Author(s):  
Brian Horsak ◽  
Mark Simonlehner ◽  
Lucas Schöffer ◽  
Bernhard Dumphart ◽  
Arian Jalaeefar ◽  
...  

Virtual reality (VR) is an emerging technology offering tremendous opportunities to aid gait rehabilitation. To this date, real walking with users immersed in virtual environments with head-mounted displays (HMDs) is either possible with treadmills or room-scale (overground) VR setups. Especially for the latter, there is a growing interest in applications for interactive gait training as they could allow for more self-paced and natural walking. This study investigated if walking in an overground VR environment has relevant effects on 3D gait biomechanics. A convenience sample of 21 healthy individuals underwent standard 3D gait analysis during four randomly assigned walking conditions: the real laboratory (RLab), a virtual laboratory resembling the real world (VRLab), a small version of the VRlab (VRLab−), and a version which is twice as long as the VRlab (VRLab+). To immerse the participants in the virtual environment we used a VR-HMD, which was operated wireless and calibrated in a way that the virtual labs would match the real-world. Walking speed and a single measure of gait kinematic variability (GaitSD) served as primary outcomes next to standard spatio-temporal parameters, their coefficients of variant (CV%), kinematics, and kinetics. Briefly described, participants demonstrated a slower walking pattern (−0.09 ± 0.06 m/s) and small accompanying kinematic and kinetic changes. Participants also showed a markedly increased gait variability in lower extremity gait kinematics and spatio-temporal parameters. No differences were found between walking in VRLab+ vs. VRLab−. Most of the kinematic and kinetic differences were too small to be regarded as relevant, but increased kinematic variability (+57%) along with increased percent double support time (+4%), and increased step width variability (+38%) indicate gait adaptions toward a more conservative or cautious gait due to instability induced by the VR environment. We suggest considering these effects in the design of VR-based overground training devices. Our study lays the foundation for upcoming developments in the field of VR-assisted gait rehabilitation as it describes how VR in overground walking scenarios impacts our gait pattern. This information is of high relevance when one wants to develop purposeful rehabilitation tools.


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