Posts Tagged gait speed

[Poster] Sensory Amplitude Electrical Stimulation Improves Gait Speed in Chronic Stroke

Purpose/Hypothesis: The objective of the study was to determine if sensory amplitude electrical stimulation (SES) delivered via sock electrode during task-specific leg exercises improved gait speed, sensation, balance, and participation in individuals with chronic stroke. It was hypothesized that SES would enhance the effectiveness of exercise, resulting in reduced impairment and improved function in individuals with post-stroke hemiplegia.

Source: Sensory Amplitude Electrical Stimulation Improves Gait Speed in Chronic Stroke – Archives of Physical Medicine and Rehabilitation

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[Abstract] Pilot study of intensive exercise on endurance, advanced mobility and gait speed in adults with chronic severe acquired brain injury – CNS

Brain Inj. 2016 Jul 28:1-7. [Epub ahead of print]

BACKGROUND AND PURPOSE: Effects of high-intensity exercise on endurance, mobility and gait speed of adults with chronic moderate-to-severe acquired brain injury (ABI) were investigated. It was hypothesized that intensive exercise would be associated with improvements in impairment and activity limitation measures.

PARTICIPANTS: Fourteen adults with chronic ABI in supported independent living who could stand with minimal or no assist and walk with or without ambulation device were studied. Eight presented with low ambulatory status.

METHODS: This was a single group pre- and post-intervention study. Participants received a 6-week exercise intervention for 60-90 minutes, 3 days/week assisted by personal trainers under physical therapist supervision. Measures (6MWT, HiMAT and 10MWT) were collected at baseline, post-intervention and 6 weeks later. Repeated measures T-test and Wilcoxon Signed Ranks test were used.

RESULTS: Post-intervention improvements were achieved on average on all three measures, greater than minimal detectable change (MDC) for this population. Three participants transitioned from low-to-high ambulatory status and maintained the change 6 weeks later.

DISCUSSION AND CONCLUSION: People with chronic ABI can improve endurance, demonstrate the ability to do advanced gait and improve ambulatory status with 6 weeks of intensive exercise. Challenges to sustainability of exercise programmes for this population remain.

Source: Traumatic Brain Injury Resource Guide – Research Reports – Pilot study of intensive exercise on endurance, advanced mobility and gait speed in adults with chronic severe acquired brain injury

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[Doctoral Project] OUTPATIENT REHABILITATION FOR A PATIENT WITH A CHRONIC LEFT ISCHEMIC STROKE – Full Text PDF

ABSTRACT

A patient with a left middle cerebral artery stroke was seen for physical therapy treatment for 8 sessions from 4/17/15 to 5/15/15 at the Department of Physical Therapy at California State University, Sacramento. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist.

The patient was evaluated at the initial encounter with the Five Times Sit to Stand to assess lower extremity muscular strength, the Six Minute Walk Test to assess cardiovascular endurance, the 10 Meter Walk Test to measure ambulatory status and gait speed, the Timed Up and Go test to measure fall risk, and the Falls Efficacy ScaleInternational to measure fall risk, and a plan of care was established. Main goals for the patient were to improve lower extremity strength, neuromuscular control, cardiovascular endurance, gait speed, and decrease risk for falls. Main interventions used were repetition, task-specific training, over-ground gait training, and neuromuscular control training.

The patient improved lower extremity strength, cardiovascular endurance, gait speed, and reduced her risk for falls. The patient was discharged to remain living at home with a home exercise program.

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[ARTICLE] Long-Term Follow-up to a Randomized Controlled Trial Comparing Peroneal Nerve Functional Electrical Stimulation to an Ankle Foot Orthosis for Patients With Chronic Stroke

Abstract

Background. Evidence supports peroneal nerve functional electrical stimulation (FES) as an effective alternative to ankle foot orthoses (AFO) for treatment of foot drop poststroke, but few long-term, randomized controlled comparisons exist.

Objective. Compare changes in gait quality and function between FES and AFOs in individuals with foot drop poststroke over a 12-month period.

Methods. Follow-up analysis of an unblinded randomized controlled trial (ClinicalTrials.gov #NCT01087957) conducted at 30 rehabilitation centers comparing FES to AFOs over 6 months. Subjects continued to wear their randomized device for another 6 months to final 12-month assessments. Subjects used study devices for all home and community ambulation. Multiply imputed intention-to-treat analyses were utilized; primary endpoints were tested for noninferiority and secondary endpoints for superiority. Primary endpoints: 10 Meter Walk Test (10MWT) and device-related serious adverse event rate. Secondary endpoints: 6-Minute Walk Test (6MWT), GaitRite Functional Ambulation Profile, and Modified Emory Functional Ambulation Profile (mEFAP). Results. A total of 495 subjects were randomized, and 384 completed the 12-month follow-up. FES proved noninferior to AFOs for all primary endpoints. Both FES and AFO groups showed statistically and clinically significant improvement for 10MWT compared with initial measurement. No statistically significant between-group differences were found for primary or secondary endpoints. The FES group demonstrated statistically significant improvements for 6MWT and mEFAP Stair-time subscore.

Conclusions. At 12 months, both FES and AFOs continue to demonstrate equivalent gains in gait speed. Results suggest that long-term FES use may lead to additional improvements in walking endurance and functional ambulation; further research is needed to confirm these findings.

Source: Long-Term Follow-up to a Randomized Controlled Trial Comparing Peroneal Nerve Functional Electrical Stimulation to an Ankle Foot Orthosis for Patients With Chronic Stroke

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[ARTICLE] Associations between lower limb strength and gait velocity following stroke: A systematic review – Full Text HTML

Abstract

Objective: The aim of this systematic review was to identify literature examining associations between isometric strength and gait velocity following stroke.

Methods: An electronic search was performed using six online databases. Targeted searching of reference lists of included articles and three relevant journals was also performed. Two independent reviewers identified relevant articles, extracted data and assessed the methodological quality of included articles. Inclusion criteria involved studies that assessed univariate correlations between gait velocity and isometric strength of individual lower limb muscle groups in a stroke population.

Results: Twenty-one studies were included for review. The majority of included studies had a relatively small sample size. After accounting for sample size and methodological quality, the knee extensors showed poor-to-moderate correlations with gait velocity while the ankle dorsiflexors showed the strongest association with gait velocity.

Conclusions: Current evidence suggests that the strength of the ankle dorsiflexors has a stronger correlation to gait velocity compared with other lower limb muscle groups. Consequently, a focus on increasing ankle dorsiflexor strength to improve gait velocity following stroke may be beneficial. However, due to limitations of the research identified, further research is needed to determine the associations between lower limb strength and gait velocity following stroke.

Continue —>  Associations between lower limb strength and gait velocity following stroke: A systematic review, Brain Injury, Informa Healthcare.

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[Doctoral Project] INPATIENT REHABILITATION FOR A PATIENT FOLLOWING A MILD RIGHT ISCHEMIC STROKE – Full Text PDF

Abstract

A patient with right anterior pons and superior cerebellar stroke was seen for
physical therapy treatment for 16 sessions from 6/11/14 to 6/23/14 at an inpatient
physical therapy clinic. Treatment was provided by a student physical therapist under the
supervision of a licensed physical therapist.
The patient was evaluated at the initial encounter with Timed Up and Go, 10 Meter
Walk Test, Dynamic Gait Index, Berg Balance Scale, and Functional Independence
Measure, and a plan of care was established. Main goals for the patient were to improve
strength, range of motion, motor control and sequencing during functional activities, gait
speed, static and dynamic standing balance, and functional independence. Main
interventions used were over-ground gait training, restorative training, task-specific
training, and functional training.

The patient improved strength, motor control and sequencing, gait speed, balance, and
functional independence. The patient was discharged to home with a home exercise
program and with follow up with outpatient physical therapy.

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[Systematic Review] A Decade of Progress Using Virtual Reality for Poststroke Lower Extremity Rehabilitation: Systematic Review of the Intervention Methods – Full Text PDF

Objective. To develop a systematic review of the literature, to describe the different virtual reality (VR) interventions and interactive videogames applied to the lower extremity (LE) of stroke patients, and to analyse the results according to the most frequently used outcome measures.

Material and Methods. An electronic search of randomized trials between January 2004 and January 2014 in different databases (Medline, Cinahl, Web of Science, PEDro, and Cochrane) was carried out. Several terms (virtual reality, feedback, stroke, hemiplegia, brain injury, cerebrovascular accident, lower limb, leg, and gait) were combined, and finally 11 articles were included according to the established inclusion and exclusion criteria.

Results.The reviewed trials showed a high heterogeneity in terms of study design and assessment tools, which makes it difficult to compare and analyze the different types of interventions. However, most of them found a significant improvement on gait speed, balance and motor function, due to VR intervention.

Conclusions. Although evidence is limited, it suggests that VR intervention (more than 10 sessions) in stroke patients may have a positive impact on balance, and gait recovery. Better results were obtained when a multimodal approach, combining VR and
conventional physiotherapy, was used. Flexible software seems to adapt better to patients’ requirements, allowing more specific and individual treatments.

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[ARTICLE] Long-Term Follow-up to a Randomized Controlled Trial Comparing Peroneal Nerve Functional Electrical Stimulation to an Ankle Foot Orthosis for Patients With Chronic Stroke

Abstract

Background: Evidence supports peroneal nerve functional electrical stimulation (FES) as an effective alternative to ankle foot orthoses (AFO) for treatment of foot drop poststroke, but few long-term, randomized controlled comparisons exist.

Objective: Compare changes in gait quality and function between FES and AFOs in individuals with foot drop poststroke over a 12-month period.

Methods: Follow-up analysis of an unblinded randomized controlled trial (ClinicalTrials.gov #NCT01087957) conducted at 30 rehabilitation centers comparing FES to AFOs over 6 months. Subjects continued to wear their randomized device for another 6 months to final 12-month assessments. Subjects used study devices for all home and community ambulation. Multiply imputed intention-to-treat analyses were utilized; primary endpoints were tested for noninferiority and secondary endpoints for superiority. Primary endpoints: 10 Meter Walk Test (10MWT) and device-related serious adverse event rate. Secondary endpoints: 6-Minute Walk Test (6MWT), GaitRite Functional Ambulation Profile, and Modified Emory Functional Ambulation Profile (mEFAP).

Results: A total of 495 subjects were randomized, and 384 completed the 12-month follow-up. FES proved noninferior to AFOs for all primary endpoints. Both FES and AFO groups showed statistically and clinically significant improvement for 10MWT compared with initial measurement. No statistically significant between-group differences were found for primary or secondary endpoints. The FES group demonstrated statistically significant improvements for 6MWT and mEFAP Stair-time subscore.

Conclusions: At 12 months, both FES and AFOs continue to demonstrate equivalent gains in gait speed. Results suggest that long-term FES use may lead to additional improvements in walking endurance and functional ambulation; further research is needed to confirm these findings.

via Long-Term Follow-up to a Randomized Controlled Trial Comparing Peroneal Nerve Functional Electrical Stimulation to an Ankle Foot Orthosis for Patients With Chronic Stroke.

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[RESEARCH PAPER] A comparison of the orthotic effect of the Odstock Dropped Foot Stimulator and the Walkaide functional electrical stimulation systems on energy cost and speed of walking in Multiple Sclerosis.

Abstract

Purpose: Functional electrical stimulation (FES), an assistive device used for foot drop, has been found to improve the speed and energy cost of walking in people with multiple sclerosis (pwMS). This study aims to compare the immediate orthotic effect on walking of two different devices; the Odstock Dropped Foot Stimulator (ODFS) and Walkaide (WA).

Method: Twenty pwMS (10 female, 10 male, mean age 50.4 ± 7.3 years) currently using ODFS were recruited. Participants walked for 5 min around an elliptical 9.5 m course at their preferred walking speed; once with ODFS, once with WA and once without FES on the same day of testing. Gait speed, distance and energy cost were measured.

Results: There was a statistically significant increase in walking speed for the ODFS (p = 0.043) and a near to significant increase for the WA (p = 0.06) in comparison to without FES. There were no differences between the ODFS and WA in terms of either walking speed (p = 0.596) or energy cost (p = 0.205).

Conclusions: This is the first pilot study to compare the effects of two different FES devices on walking. Further research recruiting a larger cohort of FES naive participants is needed.

Implications for Rehabilitation

  • Functional electrical stimulation (FES) used for foot drop in multiple sclerosis (MS) is effective in improving the speed of walking.
  • The Odstock Dropped Foot Stimulator and the Walkaide have similar orthotic effects on the speed and energy cost of walking in people with MS.
  • Further research is urgently needed to compare FES devices, recruiting treatment of naive participants for a fully powered RCT.

via A comparison of the orthotic effect of the Odstock Dropped Foot Stimulator and the Walkaide functional electrical stimulation systems on energy cost and speed of walking in Multiple Sclerosis, Disability and Rehabilitation: Assistive Technology, Informa Healthcare.

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[WEB SITE] Bioness L300 Foot Drop System Progressively Improves Walking Speed in Stroke Survivors

…“This study demonstrates that subjects with chronic stroke can achieve a meaningful improvement in the speed of their ambulation with functional electrical stimulation therapy. Moreover at 42 weeks the subjects in this study walked faster with and without the device indicating a therapeutic effect that can be sustained over time.”…

via Bioness L300 Foot Drop System Progressively Improves Walking Speed in Stroke Survivors – News Press Release | PharmiWeb.com.

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