Posts Tagged stride length

[Abstract] High Intensity Exercise for Walking Competency in Individuals with Stroke: A Systematic Review and Meta-Analysis

Abstract

OBJECTIVE:

To assess the effects of high intensity exercise on walking competency in individuals with stroke.

DATA SOURCES:

A systematic electronic searching of the PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCOhost), and SPORTSDiscus (EBSCOhost) was initially performed up to June 25, 2019.

STUDY SELECTION:

Randomized controlled trials or clinical controlled trials comparing any walking or gait parameters of the high intensity exercise to lower intensity exercise or usual physical activities were included. The risk of bias of included studies was assessed by the Cochrane risk of bias tool. The quality of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system.

DATA EXTRACTION:

Data were extracted by 2 independent coders. The mean and standard deviation of the baseline and endpoint scores after training for walking distance, comfortable gait speed, gait analysis (cadence, stride length, and the gait symmetry), cost of walking, Berg Balance Scale , Time Up&Go (TUG) Test and adverse events were extracted.

DATA SYNTHESIS:

A total of 22 (n = 952) studies were included. Standardized mean difference (SMD), weighted mean difference (WMD), and odds ratios (ORs) were used to compute effect size and subgroup analysis was conducted to test the consistency of results with different characteristics of exercise and time since stroke. Sensitivity analysis was used to assess the robustness of the results, which revealed significant differences on walking distance (SMD = .32, 95% CI, .17-.46, P < .01, I2 = 39%; WMD = 21.76 m), comfortable gait speed (SMD = .28, 95% CI, .06-.49, P = .01, I2 = 47%; WMD = .04 m/s), stride length (SMD = .51, 95% CI, .13-.88, P < .01, I2 = 0%; WMD = .12 m) and TUG (SMD = -.36, 95% CI, -.72 to .01, P = .05, I2 = 9%; WMD = -1.89 s) in favor of high intensity exercise versus control group. No significant differences were found between the high intensity exercise and control group in adverse events, including falls (OR = 1.40, 95% CI, .69-2.85, P = .35, I2 = 11%), pain (OR = 3.34, 95% CI, .82-13.51, P = .09, I2 = 0%), and skin injuries (OR = 1.08, 95% CI, .30-3.90, P = .90, I2 = 0%).

CONCLUSIONS:

This systematic review suggests that high intensity exercise could be safe and more potent stimulus in enhancing walking competency in stroke survivors, with a capacity to improve walking distance, comfortable gait speed, stride length, and TUG compared with low to moderate intensity exercise or usual physical activities.

 

via High Intensity Exercise for Walking Competency in Individuals with Stroke: A Systematic Review and Meta-Analysis. – PubMed – NCBI

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[ARTICLE] Relationships of balance, gait performance and functional outcome in chronic stroke patients: a comparison of left and right lesion – Full Text PDF

Abstract

Introduction: Stroke is the leading cause of disability in adults. The correlations of balance and gait parameters are important for assessing and rehabilitating these patients. The purpose of this study was to compare the sense of balance by center of pressure (COP) sway and its relationship with gait parameters and functional independence in left (LH) and right (RH) chronic stroke patients. Twenty-one hemiparetic stroke patients treated at the hemiplegia outpatient clinic were invited to participate in this cross-sectional study. Patients were assessed for dominance, spasticity, injury time, muscle strength, and Functional Independence Measure (FIM). The COP sway was assessed with a force platform. For gait evaluation, patients were asked to walk along a preestablished path in the Motion Analysis Laboratory. The amplitudes of the COP in the anteroposterior (RH- 3.0±1.4 cm and LH-3.1±1.2) and mediolateral (RH- 1.7±1.2 and LH-1.5±0.5 cm) directions were similar in both groups. The parameters considered were length of steps and stride, single stance, gait velocity, and cadence.

Results: only the temporal parameters showed any statistically significant differences. All patients spent more time in the stance phase for the healthy lower limb (LH; p=0.0004; RH; p=0.001), specifically the single stance time. There was no difference in the performance of balance, gait, and functional independence among groups of chronic hemiparetic stroke patients when comparing left and right hemisphere lesions. The LH showed a significant (p<0.05) correlation between stride length, step length, and gait velocity with COP velocity sway for the healthy and paretic lower limbs. In both groups the area of COP was significantly correlated with stride length. Motor FIM was significantly correlated (r=-0.59, p<0.05) with the COP area sway in the left hemiparesis group.

Conclusion: There was no difference in the performance of balance, gait, and functional independence between groups. The left hemiparesis group showed a better correlation of COP and gait parameters than did the right hemiparesis group. The correlation of the COP sway area with stride length in both groups can serve as a guideline in the rehabilitation of these patients where training the static balance may reflect the improvement of the stride length.

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