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Clinical Criteria to Perform the Step through Step Gait with a Cane in Chronic Stroke Patients

  • Kim, Won-Bok (Department of Physical Therapy, Daegu University) ;
  • Lee, Jung-Ho (Department of Physical Therapy, Soonchunhyang University Hospital)
  • Received : 2014.07.11
  • Accepted : 2014.08.08
  • Published : 2014.08.31

Abstract

PURPOSE: The purpose of this study was to propose clinical criteria to differentiate patients who are able to perform the step-through-step gait pattern in chronic stroke patients. METHODS: Sixty patients with chronic stroke patients participated this study. To differentiate patients who could perform the step-through-step gait pattern, age, gender, and causes of stroke were noted, a Chedoke-McMaster (CM) damage list, Fugl-Meyer (FM) assessment scales and the Berg Balance Scale (BBS) were determined. A 10 meter gait test and Timed Up and Go (TUG) test were conducted to determine the differences in gait speed and dynamic balance between patients walking with or without canes in the step-through-step gait pattern group. RESULTS: There was no significant statistical difference in age, gender, and stroke type between all subjects. There were significant differences in the CM scale for postural and lower extremities, and FM scale for lower extremities and BBS. The dynamic balance ability and gait speed showed significant differences between the subjects in the step-through-step gait pattern with or without a cane during gait. CONCLUSION: CM and FM scales for the lower extremities and postural control, as well as BBS scales, can be used as criteria to differentiate patients who are able to perform the step-through-step gait pattern. These results can also be used to provide beneficial information to patients that are walking with canes.

Keywords

References

  1. Aminzadeh F, Edwards N. Exploring seniors' views on the use of assistive devices in fall prevention. Public health nursing. 1998;15(4):297-304. https://doi.org/10.1111/j.1525-1446.1998.tb00353.x
  2. Allet L, Leemann B, Guyen E, et al. Effect of different walking aids on walking capacity of patients with poststroke hemiparesis. Arch Phys Med Rehabil. 2009;90(8): 1408-13. https://doi.org/10.1016/j.apmr.2009.02.010
  3. Barra J, Oujamaa L, Chauvineau V, et al. Asymmetric standing posture after stroke is related to a biased egocentric coordinate system. Neurology. 2009;72(18):1582-7. https://doi.org/10.1212/WNL.0b013e3181a4123a
  4. Beauchamp MK, Skrela M, Southmayd D, et al. Immediate effects of cane use on gait symmetry in individuals with subacute stroke. Physiother Can. 2009;61(3):154-60. https://doi.org/10.3138/physio.61.3.154
  5. Berg KO, Wood-Dauphinee SL, Williams JI et al. Measuring balance in eld erly: preliminary development of an instrument. Physiotherapy Canada. 1989;41(6): 304-11. https://doi.org/10.3138/ptc.41.6.304
  6. Bobath, B. Adult hemiplegia: evaluation and treatment(Vol. 3). Oxford. Heinemann Medical Books. 1990.
  7. Bohannon RW. Relationship among paretic knee extension strength, maximum weight- bearing and gait speed in patients with stroke. J Stroke Cerebrovasc Dis. 1991;1(2):65-9. https://doi.org/10.1016/S1052-3057(11)80003-0
  8. Boonsinsukh R, Panichareon L, Phansuwan-Pujito P. Light touch cue through a cane improves pelvic stability during walking in stroke. Arch Phys Med Rehabil. 2009;90(6):919-26. https://doi.org/10.1016/j.apmr.2008.12.022
  9. Brunnstrom S. Motor testing procedures in hemiplegia: based on sequential recovery stages. Phys Ther. 1966;46(4): 357-75. https://doi.org/10.1093/ptj/46.4.357
  10. Gowland C, Stratford P, Ward M, et al. Measuring physical impairment and disability with the Chedoke- McMaster Stroke Assessment. Stroke. 1993;24(1):58-63. https://doi.org/10.1161/01.STR.24.1.58
  11. Fugl-Meyer AR, Jaasko L, Leyman I et al. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975;7(1):13-31.
  12. Dean E, Ross J. Relationships among cane fitting, function, and falls. Phys Ther. 1993;73(8):494-500. https://doi.org/10.1093/ptj/73.8.494
  13. de Oliveira R, Cacho EW, Borges G. Post-stroke motor and functional evaluations: a clinical correlation using Fugl-Meyer assessment scale, Berg balance scale and Barthel index. Arq Neuropsiquiatr. 2006;64(3B):731-5. https://doi.org/10.1590/S0004-282X2006000500006
  14. Gowland C, Stratford P, Ward M, et al. Measuring physical impairment and disability with the Chedoke- McMaster Stroke Assessment. Stroke. 1993;24(1):58-63. https://doi.org/10.1161/01.STR.24.1.58
  15. Genthon N, Rougier P, Gissot AS, et al. Contribution of each lower limb to upright standing in stroke patients. Stroke. 2008;39(6):1793-9. https://doi.org/10.1161/STROKEAHA.107.497701
  16. Gladstone DJ, Danells CJ, Black SE. The Fugl-Meyer assessment of motor recovery after stroke: a critical review of its measurement properties. Neurorehabil Neural Repair. 2002;16(3):232-40. https://doi.org/10.1177/154596802401105171
  17. Horvath M, Tihanyi T, Tihanyi J. Kinematic and kinetic analyses of gait patterns in hemiplegic patients. Facta universitatis-series: Physical Education and Sport. 2001;1(8):25-35.
  18. Kuan TS, Tsou JY, Su FC. Hemiplegic gait of stroke patients: the effect of using a cane. Arch Phys Med Rehabil. 1999;80(7):777-84. https://doi.org/10.1016/S0003-9993(99)90227-7
  19. Kwak KH Effect of Pelvic Tilting Exercise and Gait Training on Gait Characteristics of the Patients with Hemiplegia. Master's degree. 2003.
  20. Laufer Y. Effects of one-point and four-point canes on balance and weight distribution in patients with hemiparesis. Clin Rehabil. 2002;16(2):141-8. https://doi.org/10.1191/0269215502cr481oa
  21. Patterson SL, Forrester LW, Rodgers MM, et al. Determinants of walking function after stroke: differences by deficit severity. Arch Phys Med Rehabil. 2007;88(1):115-9. https://doi.org/10.1016/j.apmr.2006.10.025
  22. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39(2):142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  23. Schmid A, Duncan PW, Studenski S, et al. Improvements in speed-based gait classifications are meaningful. Stroke. 2007;38(7):2096-100. https://doi.org/10.1161/STROKEAHA.106.475921
  24. Tyson SF, Rogerson L. Assistive walking devices in nonambulant patients undergoing rehabilitation after stroke: the effects on functional mobility, walking impairments, and patients' opinion. Arch Phys Med Rehabil. 2009;90(3):475-9. https://doi.org/10.1016/j.apmr.2008.09.563
  25. Watson MJ. Refining the ten-metre walking test for use with neurologically impaired people. Physiotherapy 2002; 88(7):386-97. https://doi.org/10.1016/S0031-9406(05)61264-3

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