The Effect of Treadmill-based Incremental Leg Weight Loading Training on the Balance of Stroke Patients

Effect of Scapular Stabilization Exercise during Standing on Upper Limb Function and Gait Ability of Stroke Patients

Background

The purpose of this study was to determine the effect of scapular stabilization exercise during standing on a paretic side on upper limb function and gait ability of stroke patients.

Methods

This study was a hospital-based, randomized controlled trial with a blinded assessor. A total of 17 patients with hemiplegic diagnosis after stroke were divided into two groups (9 patients in a study group and 8 patients in a control group). The study group received physical therapy and scapular stabilization exercise on a paretic side. Participants were subjected to initial evaluation before the treatment. Subjects were subsequently re-evaluated 4 and 8 weeks later to compare the changes. Measurements of hand function and gait ability were performed.

Results

Based on multivariate analysis of variance for repeated-measures, there was a significant time effect for Timed Up and Go test (TUG) (F = 13.816, P = 0.000), Functional Gait Assessment (FGA) (F = 18.613, P = 0.000), and manual function test (MFT) (F = 16.777, P = 0.000). The group × time interaction effect was also significant for FGA (F = 4.966, P = 0.024) and MFT (F = 6.946, P = 0.003), but not for TUG test (F = 3.343, P = 0.069).

Conclusion

Results of the present study indicated that scapular stabilization exercise during standing on a paretic side for 8 weeks had an effect on hand function and gait ability of hemiplegic patients after stroke. Further studies are needed to find the most proper exercise for stroke patients who have gait disability and upper limb dysfunction.

Kinematic head and trunk strategies used by hemiplegic stroke patients crossing over obstacles of different heights

[Purpose] The purpose of this study was to compare kinematic data regarding the head, trunk, and pelvis strategies used by individuals with hemiplegia when crossing over obstacles of different heights. [Subjects and Methods] Nine adults with hemiplegia from stroke (7 males and 2 females) participated in this study. A motion analysis system with six infrared cameras was used to measure the kinematic data of the head, trunk, and pelvis while the subjects crossed over obstacles of different heights. Repeated measures ANOVA analysis was performed to compare the resulting kinematic data. [Results] An increase in the magnitude of the kinematic data of the head, trunk, and pelvis of the hemiparetic stroke patients was observed when the height of the obstacles, which they crossed over, increased. [Conclusion] This study described the kinematic strategies, with regard to the head, trunk, and pelvis, used by hemiplegic patients crossing over obstacles of different heights. The results indicate that these kinematic strategies primarily change when the obstacle height was 20% of the height of the subjects.

Effects of gait training with rhythmic auditory stimulation on gait ability in stroke patients

[Purpose] The purpose of this study was to compare the gait abilities and motor recovery abilities in stroke patients following overground gait training with or without rhythmic auditory stimulation. [Subjects and Methods] Forty patients with hemiplegia resulting from stroke were divided into a rhythmic auditory stimulation gait training group (n=20) and a gait training group (n=20). The rhythmic auditory simulation gait group and gait training group both performed gait training. Rhythmic auditory stimulation was added during gait training in the rhythmic auditory stimulation gait training group. The gait training was performed in 30 minute sessions, five times a week, for a total four weeks. [Results] Gate ability significantly improved in both groups, and the rhythmic auditory stimulation gait training group showed more significant increases in cadence, step length, and Dynamic Gait Index. [Conclusion] The results of this study showed that gait training with rhythmic auditory stimulation was more effective at improving gait ability.

How effective is the early fast treadmill gait speed training for stroke patients at the 2nd week after admission: comparison with comfortable gait speed at the 6th week

[Purpose] The purpose of this study was to find whether a fast treadmill gait training speed is effective for the gait training of stroke patients in the early rehabilitation stage. [Subjects and Methods] Thirty-nine stroke patients were the subjects of our investigation. They walked on a treadmill with handrail supports at a fast speed (130% of their comfortable gait speed in the 2nd week). The treadmill gaits of the patients were recorded using a 3-dimensional analysis system at two and six weeks after their admissions. Intraclass Correlation Coefficients (ICC) of the temporal and spatial parameters of the two periods were statistically analyzed. [Results] For all of the patients, the ICCs of the measured parameters were greater than 0.58. In the case of patients whose gait speeds of the two periods were close, the ICC units were greater than 0.7. [Conclusion] The fast gait speed training allowed us to expose the patients to a gait speed that they were expected to acquire at a later stage of their rehabilitation. This training method was found to be beneficial for the mildly paralyzed patients.

Effect of rehabilitational sliding machine and ergometer bicycle training on patients with hemiplegia

[Purpose] The purpose of the study was to investigate the effects of exercise using rehabilitational sliding machine training and ergometer bicycle training on the balance and gait of patients with stroke. [Subjects] Forty patients with hemiplegia resulting from stroke were divided into a sliding training group (STG, n=20) and ergometer bicycle training group (ETG, n=20). [Methods] STG and ETG respectively performed rehabilitational sliding training and cycle ergometer training in 30 minute sessions, five times a week, for a total of eight weeks. [Results] The balance and gait ability of both groups significantly improved. Both groups showed improvements in balance and gait ability, and the ETG showed anterior and posterior ranges of the limit of stability following standing. [Conclusion] Training on a rehabilitational sliding machine and an ergometer is effective at increasing a patient's balance and gait ability during nontreatment time in their daily time without therapist.

Effects of gait training with horizontal impeding force on gait and balance of stroke patients

[Purpose] The purpose of this study was to investigate the effects of treadmill training with a horizontal impeding force applied to the center of upper body mass on the gait and balance of post-stroke patients. [Subjects and Methods] Twenty-four subjects with hemiplegia less than 3 months after stroke onset were randomly assigned to 2 groups: an applied horizontal impeding force on treadmill training (experimental) group (n = 12), and a control group (n = 12). Both groups walked on a treadmill at a comfortable or moderate speed for 20 minutes per day, 3 sessions per week for 8 weeks after a pre-test. The experimental group also had a horizontal impeding force applied to the center of their upper body mass. [Results] All groups demonstrated significant improvement after 8 weeks compared to baseline measurements. In intra-group comparisons, the subjects’ gait ability (CGS, MGS, cadence, and step length) and balance ability (TUG, BBS, and FRT) significantly improved. In inter-group comparisons, the experimental group’s improvement was significantly better in CGS MGS, cadence, step length, TUG, and BBS, but not in FRT. [Conclusion] Treadmill training was identified as an effective training method that improved gait and balance ability. A horizontal impeding force applied during treadmill training was more effective than treadmill walking training alone at improving the gait and dynamic balance of patients with stroke.

Effect of forced use of the lower extremity on gait performance and mobility of post-acute stroke patients

[Purpose] The purpose of this study was to investigate the effects of a forced-use training program on gait, mobility and quality of life of post-acute stroke patients. [Subjects] Twenty-one individuals with unilateral stroke participated in this study. All participants had suffered from first-ever stroke with time since onset of at least 3 months. [Methods] A single-blinded, non-equivalent, pre-post controlled design with 1-month follow-up was adopted. Participants received either a forced-use or a conventional physical therapy program for 2 weeks. The main outcomes assessed were preferred and fastest walking velocities, spatial and temporal symmetry indexes of gait, the timed up and go test, the Rivermead Mobility Index, and the Stroke-Specific Quality of Life Scale (Taiwan version). [Results] Forced-use training induced greater improvements in gait and mobility than conventional physical therapy. In addition, compared to pre-training, patients in the conventional physical therapy group walked faster but more asymmetrically after training. However, neither program effectively improved in-hospital quality of life. [Conclusion] The forced-use approach can be successfully applied to the lower extremities of stroke patients to improve mobility, walking speeds and symmetry of gait.

The effect of a rehabilitational sliding machine and conventional neurological physical therapy on the balance of patients with hemiplegia

[Purpose] The purpose of this study was to investigate the effects of exercise using a rehabilitational sliding machine and conventional neurological physical therapy on the balance of stroke patients. [Subjects] Forty patients with hemiplegia resulting from stroke were divided into a rehabilitational sliding machine exercise group (ST group, n=20) and a conventional neurological physiotherapy group (C group, n=20). [Methods] The STG underwent training with a rehabilitation sliding machine for 30 minutes per day, five times per week for eight weeks. The CG underwent training with a conventional neurological physiotherapy for 30 minutes per day, five times per week for eight weeks. [Results] The balance ability of both groups significantly improved. Although there were significant differences between the groups, the CG showed weight bearing on the affected side, an anterior range within the stability limits standing, and a posterior range within the stability limits standing. [Conclusion] The results of this study suggest that conventional neurological physiotherapy is a more dedicated, effective intervention than rehabilitational sliding training methods.