Article

Fast treadmill training improves walking speed to a greater extent
than training at a self-selected speed after stroke. It is unclear whether fast
treadmill walking facilitates a more normal gait pattern after stroke, as has
been suggested for treadmill training at self-selected speeds. Given the massed
stepping practice that occurs during treadmill training, it is important for
therapists to understand how the treadmill speed selected influences the gait
pattern that is practiced on the treadmill. OBJECTIVE: The purpose of this study
was to characterize the effect of systematic increases in treadmill speed on
common gait deviations observed after stroke. DESIGN: A repeated-measures design
was used. METHODS: Twenty patients with stroke walked on a treadmill at their
self-selected walking speed, their fastest speed, and 2 speeds in between. Using
a motion capture system, spatiotemporal gait parameters and kinematic gait
compensations were measured. RESULTS: Significant improvements in paretic- and
nonparetic-limb step length and in single- and double-limb support were found.
Asymmetry of these measures improved only for step length. Significant
improvements in paretic hip extension, trailing limb position, and knee flexion
during swing also were found as speed increased. No increases in circumduction or
hip hiking were found with increasing speed. Limitations Caution should be used
when generalizing these results to survivors of a stroke with a self-selected
walking speed of less than 0.4 m/s. This study did not address changes with speed
during overground walking. CONCLUSIONS: Faster treadmill walking facilitates a
more normal walking pattern after stroke, without concomitant increases in common
gait compensations, such as circumduction. The improvements in gait deviations
were observed with small increases in walking speed.

Langue : ANGLAIS