The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
권호 표지

The Effect of Gait Training of Progressive Increasing in Body Weight Support and Gait Speed on Stroke Patients

점진적 체중지지와 보행속도 증가 훈련이 뇌졸중 환자의 보행에 미치는 효과

  • Kim, Sung-Hoon (Department of Physical Therapy, College of Health Sports Science, Daejeon University) ;
  • Choi, Jong-Duk (Department of Physical Therapy, College of Natural Science, Daejeon University)
  • 김성훈 (대전대학교 보건스포츠대학원 물리치료학과) ;
  • 최종덕 (대전대학교 자연과학대학 물리치료학과)
  • Received : 2013.09.10
  • Accepted : 2013.10.07
  • Published : 2013.10.25
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The aim of this study was to evaluate the effect of progressive body weight decrease combined with increasing level of overground walking speed training for patients with chronic stroke. Methods: Eighteen subjects with chronic stroke were composed of the control group (5% body weight support combined with increasing speed training) and the experimental group (progressive body weight decrease with increasing speed training); three sets, three times per week over a period of four weeks. Results: Significant differences in terms of comfortable gait speed (CGS) and the rate of change of CGS were observed between the control and experimental groups (p<0.05). However, no significant difference in the dynamic gait index was observed between the control and experimental groups (p>0.05). A significant difference in the 6 minute walking test (6MWT) was observed for the experimental group, and a significant difference in the rate of change for the 6MWT was observed between the control and experimental groups (p<0.05). Conclusion: The progressive body weight decrease combined with increasing in level of overground walking speed training may be a better and more effective method for community walking and reintegration.

Keywords

References

  1. Kim MH, Lee WH, Yun MJ. The effects on respiratory strength training on respiratory function and trunk control in patient with stroke. J Kor Soc Phys Ther. 2012;24(5):340-7.
  2. Yang DJ, Park SK, Lee JH, Kang JI, Chun DH. Influence of transition from the half-kneel to standing posture in hemiplegic patients. J Kor Soc Phys Ther. 2011;23(5):49-56. https://doi.org/10.1589/jpts.23.49
  3. raun SM, Beurskens AJ, van Kroonenburgh SM et al. Effects of mental practice embedded in daily therapy compared to therapy as usual in adult stroke patients in dutch nursing homes: Design of a randomised controlled trial. BMC Neurology. 2007;7:34. https://doi.org/10.1186/1471-2377-7-34
  4. Wevers L, van de Port I, Vermue M et al. Effects of taskorientedcircuit class training on walking competency after stroke a systematic review. Stroke. 2009;40(7):2450-9. https://doi.org/10.1161/STROKEAHA.108.541946
  5. Jorgensen HS, Nakayama H, Raaschou HO et al. Recovery of walking function in stroke patients: The copenhagen stroke study. Archives of physical medicine and rehabilitation. 1995;76(1):27-32. https://doi.org/10.1016/S0003-9993(95)80038-7
  6. Lord SE, McPherson K, McNaughton HK et al. Community ambulation after stroke: How important and obtainable is it and what measures appear predictive? Archives of physical medicine and rehabilitation. 2004;85(2):234-9. https://doi.org/10.1016/j.apmr.2003.05.002
  7. Park SK, Kang YH. Effects of weight distribution and balance with foot orthotics in hemiplegic patients. J Kor Soc Phys Ther. 2012;24(2):241-6. https://doi.org/10.1589/jpts.24.241
  8. Lee MS, Lee JH, Park SK, Kang JI. The effect of ankle joint taping applied to patients with hemiplegia on their gait velocity and joint angles. J Kor Soc Phys Ther. 2012;24(2):157-62. https://doi.org/10.1589/jpts.24.157
  9. Roth EJ, Merbitz C, Mroczek K et al. Hemiplegic gait: Relationships between walking speed and other temporal parameters1. American journal of physical medicine & rehabilitation. 1997;76(2):128-33. https://doi.org/10.1097/00002060-199703000-00008
  10. Kim MG, Kim JH, Park JW. The effect of turning training on figure of 8 tract on stoke patients' balance and walking. J Kor Soc Phys Ther. 2012;24(2):143-50. https://doi.org/10.1589/jpts.24.143
  11. Lee J, Lee KN. Effects of single-leg stance training of the involved leg on standing balance and mobility in patients with subacute hemiplegia. J Kor Soc Phys Ther. 2011;23(4):1-6. https://doi.org/10.1589/jpts.23.1
  12. m SJ, Jeon CB, Kim CS. The effect of backward walking training methods on walking in stroke patients. J Kor Soc Phys Ther. 2011;23(3):21-7. https://doi.org/10.1589/jpts.23.21
  13. Lord SE, Rochester L. Measurement of community ambulation after stroke current status and future developments. Stroke. 2005;36(7):1457-61. https://doi.org/10.1161/01.STR.0000170698.20376.2e
  14. Olney SJ, Richards C. Hemiparetic gait following stroke. Part i: Characteristics. Gait & Posture. 1996;4(2):136-48. https://doi.org/10.1016/0966-6362(96)01063-6
  15. Perry J, Garrett M, Gronley JK et al. Classification of walking handicap in the stroke population. Stroke. 1995;26(6):982-9. https://doi.org/10.1161/01.STR.26.6.982
  16. Moseley AM, Stark A, Cameron ID et al. Treadmill training and body weight support for walking after stroke. Stroke. 2003;34(12):3006. https://doi.org/10.1161/01.STR.0000102415.43108.66
  17. Kendrick C, Holt R, McGlashan K et al. Exercising on a treadmill to improve functional mobility in chronic stroke: Case report. Physiotherapy. 2001;87(5):261-5. https://doi.org/10.1016/S0031-9406(05)60788-2
  18. Traballesi M, Porcacchia P, Averna T et al. Energy cost of walking measurements in subjects with lower limb amputations: A comparison study between floor and treadmill test. Gait & Posture. 2008;27(1):70-5. https://doi.org/10.1016/j.gaitpost.2007.01.006
  19. Visintin M, Barbeau H. The effects of parallel bars, body weight support and speed on the modulation of the locomotor pattern of spastic paretic gait. A preliminary communication. Spinal Cord.1994;32(8):540-53. https://doi.org/10.1038/sc.1994.86
  20. Fisher BE, Sullivan KJ. Activity-dependent factors affecting poststroke functional outcomes. Topics in stroke rehabilitation. 2001;8(3):31-44. https://doi.org/10.1310/B3JD-NML4-V1FB-5YHG
  21. Norman KE, Pepin A, Ladouceur M et al. A treadmill apparatus and harness support for evaluation and rehabilitation of gait. Archives of physical medicine and rehabilitation. 1995;76(8):772-8. https://doi.org/10.1016/S0003-9993(95)80533-8
  22. Hesse S, Bertelt C, Jahnke M et al. Treadmill training with partial body weight support compared with physiotherapy in nonambulatory hemiparetic patients. Stroke. 1995;26(6):976-81. https://doi.org/10.1161/01.STR.26.6.976
  23. Sullivan KJ, Knowlton BJ, Dobkin BH. Step training with body weight support: Effect of treadmill speed and practice paradigms on poststroke locomotor recovery. Archives of physical medicine and rehabilitation. 2002;83(5):683-91. https://doi.org/10.1053/apmr.2002.32488
  24. Hesse S, Werner C, Paul T et al. Influence of walking speed on lower limb muscle activity and energy consumption during treadmill walking of hemiparetic patients. Archives of physical medicine and rehabilitation. 2001;82(11):1547-50. https://doi.org/10.1053/apmr.2001.26607
  25. Malouin F, Potvin M, Prévost J et al. Use of an intensive taskoriented gait training program in a series of patients with acute cerebrovascular accidents. Physical Therapy. 1992;72(11):781-9.
  26. Barbeau H, Visintin M. Optimal outcomes obtained with bodyweight support combined with treadmill training in stroke subjects. Archives of physical medicine and rehabilitation. 2003;84(10):1458-65. https://doi.org/10.1016/S0003-9993(03)00361-7
  27. Kim SY, Lee JH, An SH. The clinical application of modified emory functional ambulation profile for chronic stroke patients. Journal of the Korean Society of Physical Medicine. 2010;5(4):655-66.
  28. Maureen K Holden, Kathleen M Gill, Marie R Magliozzi et al. Clinical gait assessment in the neurologically impaired. Reliability and meaningfulness. Physical therapy. 1984;64(1):35-40.
  29. Hunt SM, McKenna S, Williams J. Reliability of a population survey tool for measuring perceived health problems: A study of patients with osteoarthrosis. Journal of epidemiology and community health. 1981;35(4):297-300. https://doi.org/10.1136/jech.35.4.297
  30. Butland R, Pang J, Gross E et al. Two-, six-, and 12-minute walking tests in respiratory disease. British medical journal (Clinical research ed). 1982;284(6329):1607. https://doi.org/10.1136/bmj.284.6329.1607
  31. Shumway-Cook A, Woollacott MH. Motor control: Theory and practical applications. Williams & Wilkins Baltimore, 1995.
  32. Lim JH, Park JS, Seo SK. Correlation of curved walking ability with straight walking ability and motor function in patients with hemiplegia. J Kor Soc Phys Ther. 2011;23(3):13-9. https://doi.org/10.1589/jpts.23.13
  33. Jonsdottir J, Cattaneo D. Reliability and validity of the dynamic gait index in persons with chronic stroke. Archives of physical medicine and rehabilitation. 2007;88(11):1410-5. https://doi.org/10.1016/j.apmr.2007.08.109
  34. Kim JJ, Rho MH, Goo BO, Ahn SY. The effect of speeddependent with body weight supported treadmill training on the ambulation of stroke. J Kor Soc Phys Ther. 2005;17(3):339-50.
  35. Kim JH, An SH, Bae SS. Preliminary study of ambulation training on electromechanical gait trainer in stroke patients. Journal of the Korean Society of Physical Medicine 2006;1(1):1-12.
  36. Kim MJ, Lee JH. Effect of body weight support treadmill training on gait and standing balance in patients with hemiplegia. Physical Therapy Korea. 2003;10(1):29-35.
  37. Kim EJ, Jung JM, Kim TH, Bae SS. The effects of plantar foot pressure and muscular activity on treadmill gait training in stroke patients. Journal of the Korean Society of Physical Medicine. 2009;4(3):165-74.
  38. Lau KW, Mak MK. Speed-dependent treadmill training is effective to improve gait and balance performance in patients with sub-acute stroke. Journal of Rehabilitation Medicine. 2011;43(8):709-13.
  39. Kim SY. Effect of treadmill training on walking velocity and gait endurance in patients with chronic hemiplegia. J Kor Soc Phys Ther. 2004;16(2):44-53 .
  40. Fulk GD, Reynolds C, Mondal S et al. Predicting home and community walking activity in people with stroke. Archives of physical medicine and rehabilitation. 2010;91(10):1582-6. https://doi.org/10.1016/j.apmr.2010.07.005
  41. Pohl M, Mehrholz J, Ritschel C et al. Speed-dependent treadmill training in ambulatory hemiparetic stroke patients a randomized controlled trial. Stroke. 2002;33(2):553-8. https://doi.org/10.1161/hs0202.102365