Article

Previous studies suggest that error augmentation may be
used as a strategy to achieve longer-term changes in gait deficits after stroke.
The purpose of this study was to determine whether longer-term improvements in
step length asymmetry could be achieved with repeated split-belt treadmill
walking practice using an error augmentation strategy. METHODS: 13 persons with
chronic stroke (>6 months) participated in testing: (1) prior to 12 sessions of
split-belt treadmill training, (2) after the training, and (3) in follow-up
testing at 1 and 3 months. Step length asymmetry was the target of training, so
belt speeds were set to augment step length asymmetry such that aftereffects
resulted in reduced step length asymmetry during overground walking practice.
Each individual was classified as a "responder" or "nonresponder" based on
whether their reduction in step length asymmetry exceeded day-to-day variability.
RESULTS: For the group and for the responders (7 individuals), step length
asymmetry improved from baseline to posttesting (P < .05) through an increased
step length on both legs but a relatively larger change on the shorter step side
(P < .05). Other parameters that were not targeted (e.g., stance time asymmetry)
did not change over the intervention. CONCLUSIONS: This study demonstrates that
short-term adaptations can be capitalized on through repetitive practice and can
lead to longer-term improvements in gait deficits poststroke. The error
augmentation strategy, which promotes stride-by-stride adjustment to reduce
asymmetry and results in improved asymmetry during overground walking practice,
appears to be critical for obtaining the improvements observed.

Langue : ANGLAIS