[ARTICLE] The Effects of Visual Feedback during Recumbent Stepping in Individuals with Chronic Stroke – Full Text PDF

Abstract

Objective

To investigate the effects of intermittent visual feedback (using the Balanced Power program on the NuStep Transitt) during recumbent stepping on strength, balance and functional mobility in individuals with chronic stroke.

Design

Quasi experimental one group pre-test post-test study.

Setting

Human performance research laboratory.

Participants

Adults (n=11; 7 female; mean age 58.7 ± 13.6 years), > 6 months post-stroke.

Interventions

Eight 45-minute training sessions on the NuStep Transitt (visits 2-9) twice a week [5 minute warm-up and cool-down with 35 minutes of training (5 minutes with and then without visual feedback regarding left/right lower extremity percentage effort)]. Visits 1 and 10: pre- and post-assessment.

Main Outcome Measures

Self-selected and fast gait speeds; Maximum Voluntary Contractions (MVC) of knee extension (KE) and flexion (KF), ankle dorsiflexion (DF) and plantarflexion (PF); and Five Times Sit to Stand (5xSTS).

Results

Significant improvements in 5xSTS (14.2 sec, p=0.007) and fast gait [hemi: 4.9 cm (p=0.024), non-hemi: 4.5 cm (p=0.019) stride length; non-hemi step length 2.3 cm (p=0.024)]. MVC’s and self-selected gait parameters showed no significant changes.

Conclusions

The NuStep Transitt is a valuable tool that provides real-time feedback about percentage of use of the hemiparetic leg. This intervention study has demonstrated that the addition of visual feedback about left/right percentage effort while exercising on the Transitt has significant and clinically relevant effects on the functional mobility of individuals with chronic stroke.

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