scholarly journals Gait Parameters Associated With Responsiveness to Treadmill Training With Body-Weight Support After Stroke: An Exploratory Study

2010 ◽  
Vol 90 (2) ◽  
pp. 209-223 ◽  
Author(s):  
Sara J. Mulroy ◽  
Tara Klassen ◽  
JoAnne K. Gronley ◽  
Valerie J. Eberly ◽  
David A. Brown ◽  
...  
Keyword(s):  
Body Weight ◽  
Lower Extremity ◽  
Muscle Activation ◽  
Walking Speed ◽  
Treadmill Training ◽  
High Response ◽  
Emg Activity ◽  
Locomotor Training ◽  
Gait Parameters ◽  
Response Group

Background Task-specific training programs after stroke improve walking function, but it is not clear which biomechanical parameters of gait are most associated with improved walking speed. Objective The purpose of this study was to identify gait parameters associated with improved walking speed after a locomotor training program that included body-weight–supported treadmill training (BWSTT). Design A prospective, between-subjects design was used. Methods Fifteen people, ranging from approximately 9 months to 5 years after stroke, completed 1 of 3 different 6-week training regimens. These regimens consisted of 12 sessions of BWSTT alternated with 12 sessions of: lower-extremity resistive cycling; lower-extremity progressive, resistive strengthening; or a sham condition of arm ergometry. Gait analysis was conducted before and after the 6-week intervention program. Kinematics, kinetics, and electromyographic (EMG) activity were recorded from the hemiparetic lower extremity while participants walked at a self-selected pace. Changes in gait parameters were compared in participants who showed an increase in self-selected walking speed of greater than 0.08 m/s (high-response group) and in those with less improvement (low-response group). Results Compared with participants in the low-response group, those in the high-response group displayed greater increases in terminal stance hip extension angle and hip flexion power (product of net joint moment and angular velocity) after the intervention. The intensity of soleus muscle EMG activity during walking also was significantly higher in participants in the high-response group after the intervention. Limitations Only sagittal-plane parameters were assessed, and the sample size was small. Conclusions Task-specific locomotor training alternated with strength training resulted in kinematic, kinetic, and muscle activation adaptations that were strongly associated with improved walking speed. Changes in both hip and ankle biomechanics during late stance were associated with greater increases in gait speed.

scholarly journals The Efficacy of Gait Training Using a Body Weight Support Treadmill and Visual Biofeedback in Patients with Subacute Stroke: A Randomized Controlled Trial

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Mariusz Drużbicki ◽  
Grzegorz Przysada ◽  
Agnieszka Guzik ◽  
Agnieszka Brzozowska-Magoń ◽  
Krzysztof Kołodziej ◽  
...  
Keyword(s):  
Body Weight ◽  
Walking Speed ◽  
Gait Training ◽  
Treadmill Training ◽  
Control Group ◽  
Visual Biofeedback ◽  
Subacute Stroke ◽  
Weight Support ◽  
Gait Parameters ◽  
The Difference

Background.This study was designed to determine whether or not gait training based on the use of treadmill with visual biofeedback and body weight support (BWS) would produce better effects in patients with subacute stroke compared to BWS treadmill training with no visual biofeedback.Materials and Methods.30 patients with subacute stroke were randomly assigned to do body weight supported treadmill training with visual biofeedback (BB group) or BWS treadmill training without visual biofeedback. Their gait was assessed with a 3D system (spatiotemporal gait parameters and symmetry index) and by means of 2-minute walk test (2 MWT), 10-metre walk test (10 MWT), and Timed Up & Go test. Subjects in both groups participated in 15 treadmill training sessions (30 minutes each).Results.The participants from both groups achieved a statistically significant improvement in spatiotemporal gait parameters, walking speed, endurance, and mobility. The average change in the BB group after the end of the programme did not differ significantly compared to the change in the control group. The change in the symmetry index value of stance phase in the BB group was 0.03 (0.02) and in the control group was 0.02 (0.02). The difference was not statistically significant (p=0.902). The statistically significantly higher improvement in the BB group was found in the range of walking speed (p=0.003) and endurance (p=0.012), but the difference between groups was of low clinical significance.Conclusions.The findings do not confirm that BWS treadmill training with the function of visual biofeedback leads to significantly greater improvement in gait compared to BWS treadmill training with no visual biofeedback at an early stage after stroke. This study was registered at ClinicalTrials.gov, ID:ACTRN12616001283460.

scholarly journals Treino Locomotor com Suporte de Peso Corporal na Lesão Medular Incompleta

2001 ◽  
Vol 19 (4) ◽  
pp. 702-710
Author(s):  
Renata Teles Vieira ◽  
Rafaela Machado de Gusmão Oliveira ◽  
Camila Alves Nogueira Barros ◽  
Leonardo Caixeta
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Body Weight ◽  
Treadmill Training ◽  
Body Weight Support ◽  
Locomotor Training ◽  
Weight Support ◽  
Cord Injury

Objetivo. O objetivo deste trabalho foi realizar uma revisão de literatura sobre o uso do treino locomotor em pacientes portadores de lesão medular incompleta, a fim de verificar os seus efeitos para a marcha destes pacientes. Método. Foi realizada uma busca utilizando os bancos de dados medline, scielo e bvs a partir dos descritores: body weight-support treadmill training (suporte parcial de peso com treinamento em esteira), locomotor training (treino locomotor), spinal cord injury (lesão medular), gait (marcha). Todos os artigos coletados nos últimos 18 anos foram analisados. Discussão. A lesão medular é uma grave síndrome neurológica que causa diversos comprometimentos, inclusive da marcha. Para aperfeiçoar este processo, deu-se início à prática de reabilitação na esteira com suporte de peso corporal. A ampla utilização desta técnica de reabilitação deve-se a maior facilidade para o treino da marcha, a satisfação dos pacientes durante o tratamento e, principalmente, aos bons resultados gerados. Conclusão. Um número significante de estudos mostrou que o treino de marcha com suporte de peso corporal é um meio seguro e confiável, e que surgiu para inovar a reabilitação funcional da marcha. Não há evidência científica para afirmar que o treino locomotor com suporte de peso seja um método superior a outras terapias.

scholarly journals Changes in Locomotor Muscle Activity After Treadmill Training in Subjects With Incomplete Spinal Cord Injury

2009 ◽  
Vol 101 (2) ◽  
pp. 969-979 ◽  
Author(s):  
Monica A. Gorassini ◽  
Jonathan A. Norton ◽  
Jennifer Nevett-Duchcherer ◽  
Francois D. Roy ◽  
Jaynie F. Yang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Muscle Activity ◽  
Muscle Activation ◽  
Treadmill Training ◽  
Emg Activity ◽  
Incomplete Spinal Cord Injury ◽  
Activation Patterns ◽  
Muscle Activation Patterns ◽  
Cord Injury

Intensive treadmill training after incomplete spinal cord injury can improve functional walking abilities. To determine the changes in muscle activation patterns that are associated with improvements in walking, we measured the electromyography (EMG) of leg muscles in 17 individuals with incomplete spinal cord injury during similar walking conditions both before and after training. Specific differences were observed between subjects that eventually gained functional improvements in overground walking (responders), compared with subjects where treadmill training was ineffective (nonresponders). Although both groups developed a more regular and less clonic EMG pattern on the treadmill, it was only the tibialis anterior and hamstring muscles in the responders that displayed increases in EMG activation. Likewise, only the responders demonstrated decreases in burst duration and cocontraction of proximal (hamstrings and quadriceps) muscle activity. Surprisingly, the proximal muscle activity in the responders, unlike nonresponders, was three- to fourfold greater than that in uninjured control subjects walking at similar speeds and level of body weight support, suggesting that the ability to modify muscle activation patterns after injury may predict the ability of subjects to further compensate in response to motor training. In summary, increases in the amount and decreases in the duration of EMG activity of specific muscles are associated with functional recovery of walking skills after treadmill training in subjects that are able to modify muscle activity patterns following incomplete spinal cord injury.

Locomotor training using body weight support on a treadmill improves mobility in persons with multiple sclerosis: a pilot study

2007 ◽  
Vol 13 (2) ◽  
pp. 224-231 ◽  
Author(s):  
Barbara Giesser ◽  
Janell Beres-Jones ◽  
Amy Budovitch ◽  
Elise Herlihy ◽  
Susan Harkema
Keyword(s):  
Multiple Sclerosis ◽  
Body Weight ◽  
Walking Speed ◽  
Functional Mobility ◽  
Body Weight Support ◽  
Locomotor Training ◽  
Weight Support ◽  
Disability Status ◽  
Potential Benefits

Rationale The purpose of this protocol was to investigate the potential benefits and tolerability of locomotor training using body weight support on a treadmill (LTBWST) in persons with multiple sclerosis (MS). Methods Four persons with primarily spinal cord MS and severely impaired ambulation (Expanded Disability Status Scale score 7.0–7.5) were enrolled in LTBWST. Subjects completed an average of 40 training sessions over several months. Results Subjects showed improvement in muscle strength, spasticity, endurance, balance, walking speed, and quality of life at the end of the training sessions, and could tolerate training without fatigue or other adverse effects. Conclusions LTBWST is well tolerated by persons with MS and may produce improvements in parameters related to functional mobility. Multiple Sclerosis 2007; 13: 224–231. http://msj.sagepub.com

scholarly journals Treadmill Training in Multiple Sclerosis: Can Body Weight Support or Robot Assistance Provide Added Value? A Systematic Review

2012 ◽  
Vol 2012 ◽  
pp. 1-15 ◽  
Author(s):  
Eva Swinnen ◽  
David Beckwée ◽  
Droesja Pinte ◽  
Romain Meeusen ◽  
Jean-Pierre Baeyens ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Body Weight ◽  
Walking Speed ◽  
Descriptive Analysis ◽  
Experimental Studies ◽  
Treadmill Training ◽  
Added Value ◽  
Cochrane Library ◽  
Double Support

Purpose. This systematic review critically analyzes the literature on the effectiveness of treadmill training (TT), body-weight-supported TT (BWSTT), and robot-assisted TT (RATT) in persons with multiple sclerosis (MS), with focus on gait-related outcome measurements.Method. Electronic databases (Pubmed, Pedro, Web of Science, and Cochrane Library) and reference lists of articles and narrative reviews were searched. Pre-, quasi- and true-experimental studies were included if adult persons with MS were involved in TT, BWSTT, or RATT intervention studies published before 2012. Descriptive analysis was performed and two researchers scored the methodological quality of the studies.Results. 5 true- and 3 preexperimental studies (mean quality score: 66%) have been included. In total 161 persons with MS were involved (TT, BWSTT, or RATT, 6–42 sessions; 2–5x/week; 3–21 weeks). Significant improvements in walking speed and endurance were reported. Furthermore, improvements of step length, double-support time, and Expanded Disability Status Scale were found.Conclusions. There is a limited number of published papers related to TT in persons with MS, concluding that TT, BWSTT, and RATT improve the walking speed and endurance. However, it is not clear what type of TT is most effective. RCTs with larger but more homogeneous populations are needed.

scholarly journals Advantage in muscle activation in gait with support of body weight in spinal cord injury

2018 ◽  
Vol 31 (0) ◽  
Author(s):  
Jéssica Saccol Borin ◽  
Tânia Valdameri Capelari ◽  
Melissa Grigol Goldhardt ◽  
Márcia Cristina Issa ◽  
Diego Antônio Pereira Bica dos Santos ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Body Weight ◽  
Muscle Activation ◽  
Gait Training ◽  
Treadmill Training ◽  
Body Weight Support ◽  
Weight Support ◽  
Cord Injury ◽  
Injured Patients

Abstract Introduction: The locomotor training with body weight support has been proposed as an alternative for the rehabilitation of people with spinal cord injury, in order to develop most of the residual potential of the body. Objective: To compare the levels of muscle activation of the main muscle involved in gait during body weight-supported treadmill training and body weight-supported overground training in incomplete spinal cord injured patients. Methods: It was a prospective cross-sectional study, in which 11 incomplete injured patients were submitted to two modalities of gait with body weight support, the first one on the treadmill (two different speeds: 1 and 4km/h), and the second one with the walker on fixed floor. The electromyographical acquisition was done in the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL) and gluteus maximus (GM). Results: There was a greater muscle activation of all muscles analyzed in the treadmill training as compared to the over groundtraining, both at 4 km/h (RF: p=0.00), (VM: p=0.00), (VL: p=0.00) e (GM: p=0.00) and at 1km/h (RF: p=0.00), (VM: p=0.00), (VL: p=0.00) e (GM: p=0.00). When comparing the two modalities of treadmill training, at 4 and 1km/h, there was no statically significant difference between them (RF: p=0.36), (VM: p=1.00), (VL: p=1.00) e (GM: p=0.16). Conclusion: The gait training with body weight support is more effective in activating the muscles involved in the gait training on treadmill compared to overground training in patients with incomplete spinal cord injury.

scholarly journals Metabolic Demand and Muscle Activation during Different Forms of Bodyweight Supported Locomotion in Men with Incomplete SCI

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Alyssa M. Fenuta ◽  
Audrey L. Hicks
Keyword(s):  
Body Weight ◽  
Muscle Activation ◽  
Rectus Femoris ◽  
Biceps Femoris ◽  
Medial Gastrocnemius ◽  
Locomotor Training ◽  
Metabolic Demand ◽  
Metabolic Equivalents ◽  
Weight Support ◽  
Cord Injury

Body weight supported locomotor training uses neuroplasticity principles to improve recovery following a spinal cord injury (SCI). Steady state locomotion using the same body weight support (BWS) percent was compared in 7 males (42.6±4.29 years) with incomplete SCI and matched (gender, age) noninjured controls (42.7±5.4 years) using the Lokomat, Manual Treadmill, and ZeroG. The VO2000, Polar Heart Rate (HR) Monitor, and lower limb electromyography (EMG) electrodes were worn during the 2-minute sessions. Oxygen uptake (VO2) and HR were expressed as percentage of peak values obtained using progressive arm ergometry; VO2was also expressed relative to resting metabolic equivalents (METS). Filtered EMG signals from tibialis anterior (TA), rectus femoris (RF), biceps femoris (BF), and medial gastrocnemius (MG) were normalized to ZeroG stepping. The Lokomat required 30% of VO2peak (2METS) compared to ~54% (3METS) for Manual Treadmill and ZeroG sessions. HR was 67% of peak during Lokomat sessions compared to ~83% for Manual Treadmill and ZeroG. Muscle activation was higher in treadmill conditions compared to the ZeroG primarily due to increased BF activity. At the same level of BWS, locomotion using the Manual Treadmill or the ZeroG is more aerobically demanding than the Lokomat. Treadmill modalities encourage greater hip extensor activation compared to overground locomotion.

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