Hemiparetic gait parameters in overground versus treadmill walking

被引:116
作者
Harris-Love, ML
Forrester, LW
Macko, RF
Silver, KHC
Smith, GV
机构
[1] Univ Maryland, Sch Med, Dept Phys Therapy, Baltimore, MD 21201 USA
[2] Univ Maryland, Sch Med, Dept Neurol, Baltimore, MD 21201 USA
[3] Vet Affairs Maryland Healthcare Syst, Baltimore, MD USA
关键词
stroke; rehabilitation; hemiparetic gait; treadmill; gait symmetry;
D O I
10.1177/154596830101500204
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: Hemiparetic gait is characterized by high stride-cycle variability, diminished stance time, single-limb stance time, and stance/swing ratio in the paretic limb. Recent studies suggest treadmill (TM) training may improve the motor control underlying these variables, but supporting evidence is sparse. Methods: This study compared gait patterns of untrained chronic hemiparetic stroke patients (n = 18; mean, 39.5 months poststroke) during overground (OG) and TM walking at matched velocities. Variables included relative stance time, relative single-limb stance time, stance/swing ratio, peak force, and impulse. Within-subject variability of these measures (CV) was used to assess gait pattern stability. Results: OG and TM cycle durations were similar, but CVs differed (TM < OG, p < 0.05). In the paretic limb, differences were seen in relative stance time, relative single,limb stance time, and stance/swing ratio, respectively (TM > OG, p < 0.05). These variables decreased in the nonparetic limb during TM walking (p < 0.05 for all). Improved interlimb symmetry and coordination were evidenced by decreased between-limb differences and improved relative temporal phasing, respectively, in the TM condition (p < 0.05). Conclusions: Collectively, these results demonstrate that the TM induces an immediate alteration toward a more consistent and symmetric gait pattern. Further investigation is needed to determine whether TM training leads to motor relearning and neuroplasticity in chronic hemiparetic subjects.
引用
收藏
页码:105 / 112
页数:8
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