Article

OBJECTIVE: To investigate the effectiveness of a home-based multiple-speed
treadmill training program to improve gait performance in persons with a
transfemoral amputation (TFA). DESIGN: Repeated measures. SETTING: Research
laboratory. PARTICIPANTS: Individuals with a TFA (N=8) who had undergone a
unilateral amputation at least 3 years prior as a result of limb trauma or
cancer. INTERVENTION: Home-based treadmill walking for a total of 30 minutes a
day, 3 days per week for 8 weeks. Each 30-minute training session involved 5
cycles of walking for 2 minutes at 3 speeds. MAIN OUTCOME MEASURES: Participants
were tested pretraining and after 4 and 8 weeks of training. The primary measures
were temporal-spatial gait performance (symmetry ratios for stance phase duration
and step length), physiological gait performance (energy expenditure and energy
cost), and functional gait performance (self-selected walking speed [SSWS],
maximum walking speed [MWS], and 2-minute walk test [2MWT]). RESULTS: Eight weeks
of home-based training improved temporal-spatial gait symmetry at SSWS but not at
MWS. A relative interlimb increase in stance duration for the prosthetic limb and
proportionally greater increases in step length for the limb taking shorter steps
produced the improved symmetry. The training effect was significant for the step
length symmetry ratio within the first 4 weeks of the program. Energy expenditure
decreased progressively during the training with nearly 10% improvement observed
across the range of walking speeds. SSWS, MWS, and 2MWT all increased by 16% to
20%. CONCLUSIONS: Home-based treadmill walking is an effective method to improve
gait performance in persons with TFA. The results support the application of
training interventions beyond the initial rehabilitation phase, even in
individuals considered highly functional.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS