Article

During the physical rehabilitation of individuals poststroke,
therapists are challenged to provide sufficient amounts of task-specific practice
in order to maximize outcomes of multiple functional skills within limited
visits. Basic and applied studies have suggested that training of one motor task
may affect performance of biomechanically separate tasks that utilize overlapping
neural circuits. However, few studies have explicitly investigated the impact of
training one functional task on separate, nonpracticed tasks.
The purpose of this preliminary study was to investigate the potential gains in
specific nonlocomotor assessments in individuals poststroke following only
stepping training of variable, challenging tasks at high aerobic intensities.
METHODS: Individuals with locomotor deficits following subacute and chronic
stroke (n=22) completed a locomotor training paradigm using a repeated-measures
design. Practice of multiple stepping tasks was provided in variable environments
or contexts at high aerobic intensities for >/=40 sessions over 10 weeks. The
primary outcome was timed Five-Times Sit-to-Stand Test (5XSTS) performance, with
secondary measures of sit-to-stand kinematics and kinetics, clinical assessment
of balance, and isometric lower limb strength. RESULTS: Participants improved
their timed 5XSTS performance following stepping training, with changes in
selected biomechanical measures. Statistical and clinically meaningful
improvements in balance were observed, with more modest changes in paretic leg
strength. CONCLUSIONS: The present data suggest that significant gains in
selected nonlocomotor tasks can be achieved with high-intensity, variable
stepping training. Improvements in nonpracticed tasks may minimize the need to
practice multiple tasks within and across treatment sessions.
CI - (c) 2014 American Physical Therapy Association.

Langue : ANGLAIS