Article

OBJECTIVE: To investigate movement of the center of mass (COM) during different
gait training methods in people with neurologic conditions. DESIGN: Coordination
of the gait cycle, represented by mediolateral COM displacement amplitude,
timing, and stability, was assessed during a variety of gait training methods
performed in a single session. SETTING: Gait laboratory. PARTICIPANTS: People who
were unable to walk unassisted due to an acquired brain injury (n=17) and healthy
control subjects (n=25). INTERVENTIONS: The participants performed 7 alternative
gait training methods in a randomized order. These were therapist manual
facilitation, the use of a gait assistive device, treadmill walking with handrail
support, and 4 variations of body weight-support treadmill training with
combinations of handrail and/or therapist support. MAIN OUTCOME MEASURES:
Mediolateral COM movement was analyzed in terms of displacement amplitude
(overall range of motion), timing (relative to stride time), and stability
(steadiness of the movement). Normative values for these measures were acquired
from 25 healthy participants walking at a self-selected comfortable pace.
RESULTS: Body weight-support treadmill training without any additional support
resulted in significantly (P<.05) greater amplitude, altered timing, and reduced
movement stability compared with nonpathologic gait. Allowing handrail support or
therapist facilitation reduced this effect and resulted in treadmill training
(+/- body weight support) having lower movement amplitudes when compared with the
other training methods. Therapist manual facilitation most closely matched
nonpathologic gait for timing and stability. CONCLUSIONS: In the context of
overall dynamic gait coordination, no single method of training provides the
optimal stimulus. A training program that uses a variety of techniques may
provide a beneficial rehabilitation response.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS