Article

Gait training is an important component of rehabilitation
after lower-extremity amputation. Abnormal gait performance often persists even
for individuals who reacquire a high level of function. This case report
describes the use of a virtual reality (VR)-based gait training program that
provides real-time feedback in order to improve biomechanical and physiological
performance. The aim of this case report is to describe the effects of the
training in a person with a transfemoral amputation. DESCRIPTION: A
24-year-old man with a transfemoral amputation completed a 3-week gait training
program. The intervention consisted of 12 sessions of treadmill walking with
real-time visual feedback on full-body gait kinematics. A treating therapist
directed the patient's attention to specific gait deviations as a means to
normalize gait biomechanics. The patient completed overground
biomechanical gait analyses and multiple-speed treadmill tests 3 weeks apart
prior to and following the training program. Biomechanical gait analyses
indicated the training produced improved frontal-plane hip, pelvis, and trunk
motion during overground walking. Improvement in trunk motion was observed at the
posttraining test, and improvements in pelvis and hip motion were observed at the
3-week follow-up test. Decreases of up to 23% in oxygen consumption also were
demonstrated. DISCUSSION: Although the exact contribution of the visual feedback
could not be isolated, the training was effective in improving the patient's
walking performance. Biomechanical data suggest correcting trunk motion and
increasing hip abductor strength (force-generating capacity) may be important in
facilitating improvements at the pelvis and hip. Observed improvements in oxygen
consumption were significantly larger than achieved through previously reported
interventions.

Langue : ANGLAIS