Article

Rehabilitating walking in ambulatory patients post-stroke, with training that is
safe, task-specific, intensive,
and of sufficient duration, can be challenging.
Some challenges can be met by using body-weight-supported treadmill training
(BWSTT). However, it is not known to what degree walking characteristics are
similar during BWSTT and overground walking. In addition, important questions
regarding the training protocol of BWSTT remain unanswered, such as how
proportion of body-weight support (BWS) and walking speed affect walking
characteristics during training. The objective was therefore to investigate if
and how kinematic walking characteristics are different between overground
walking and treadmill walking with BWS in ambulatory patients post-stroke, and
the acute response of altering walking speed and percent BWS during treadmill
walking with BWS. A cross-sectional repeated-measures design was used. Ambulating
patients post-stroke walked in slow, preferred, and fast walking speed overground
and at comparable speeds on the treadmill with 20% and 40% BWS. Kinematic walking
characteristics were obtained using a kinematic sensor attached over the lower
back. Forty-four patients completed the protocol. Kinematic walking
characteristics were similar during treadmill walking with BWS, compared to
walking overground. During treadmill walking, choice of walking speed had greater
impact on kinematic walking characteristics than proportion of BWS. Faster
walking speeds tended to affect the kinematic walking characteristics positively.
This implies that in order to train safely and with sufficient intensity and duration, therapists may choose to include BWSTT in walking rehabilitation also
for ambulatory patients post-stroke without aggravating gait pattern during training.

Langue : ANGLAIS