The aim of the current study was to assess the effectiveness of backward gait training on the treadmill in patients with spastic diplegic cerebral palsy (CP). Twelve patients with spastic diplegic CP participated in the study. An 8-week course of backward gait training was administered to the subjects for 3 days per week. Pre-intervention and post-intervention assessments of temporal-spatial gait parameters, the symmetry of the bilateral lower extremity weight bearing, and gross motor function were analyzed using motion analysis system, force plate, and Gross Motor Function Measurement (GMFM). There were significant improvements (p<.05) in the measures of both step length and right stance phase time. Joint kinematics showed increase in right hip abduction in initial contact and terminal swing, right hip external rotation and knee flexion in mid-swing, left ankle dorsiflexion in initial contact and terminal swing (p<.05). The symmetry of the bilateral lower extremity weight bearing and GMFM also significantly increased (p<.05). These findings indicate that backward gait training using a treadmill is beneficial for patients with spastic diplegic CP.
Purpose: This study aimed to determine how inclined-treadmill walking training with rhythmic auditory stimulation affects balance and gait in stroke patients. Methods: Ten chronic stroke patients, admitted to B hospital in Gangwon-do between August and October 2015, were trained 5 times per week for 4 weeks; each session lasted 30 minutes. To assess balance and gait before and after the training, the timed up and go (TUG) test, Berg balance scale (BBS), six minute walking test (6MWT), and three-dimensional spatiotemporal gait ability were used to measure the relevant variables. The data were analyzed using the paired t-test, and the statistical significance level was 0.05. Results: There were significant differences in the TUG, BBS, 6MWT, gait speed, cadence, single limb support (SLS), and symmetric index (SI) before and after training (p < 0.05). Conclusion: The results showed that the inclined-treadmill walking training with rhythmic auditory stimulation was effective at improving the balance and walking ability of stroke patients. Hearing training, using one of the basic procedures of proprioceptive neuromuscular stimulation, is considered to be an important aspect.
The purpose of this study was to apply treadmill training through motor learning to cerebral palsy children and examine its effects on their Gross Motor Functions. The subjects of this study were 13 spastic diplegia children who had difficulty in independent gait, and GMFCS level III, IV. We performed treadmill gait training using the principle of weight bearing, based on 4times a week for 30 minutes before and after each session physical therapy we gave weight bearing treadmill training 5 to 10 minutes, during 7 weeks(April 9, 2012~May 26, 2012) fittingly for the children's gait characteristics. In order to test how the weight bearing treadmill training affects spastic diplegia children's gross motor functions, we measured body mobility with Gross Motor Function Measure (GMFM). These data were collected before and after the experiment and analyzed through comparison. Data collected from the 13 spastic diplegia children the results were as follows. For evaluating with regard to change in body mobility, significant difference was observed between before and after the experiment in measured gross motor functions, which were crawling, kneeling, standing, walking, jumping and running(p<0.05). According to the results of this study, when gait training through motor learning was applied to spastic cerebral palsy children, it made significant changes in their body mobility. Accordingly, for the effective application of gait training through motor learning to cerebral palsy children, it is considered necessary to make research from different angle on how such training affects children's mobility, activity of muscles in the lower limbs, and gait characteristics.
Purpose: The purpose of this study was both to examine the effects of proprioceptive neuromuscular facilitation (PNF) lower leg taping and treadmill training on the gait and balance abilities of patients with hemiplegia resulting from a stroke and to provide a taping method based on the PNF concept. Methods: Twenty patients with hemiplegia resulting from a stroke were randomly and equally assigned to a control group (n=10), which received treadmill training, and to an experimental group (n=10), which received PNF lower leg taping and treadmill training. The intervention was conducted five times per week for six weeks. In order to measure changes in the gait ability of the subjects, a 10-meter walking test (10MWT) and a 6-minute walking test (6MWT) were conducted, and in order to measure changes in the subjects' balance ability, a timed up and go test (TUG) was performed. In order to compare differences within each group before and after the intervention, a paired-t test was carried out, and in order to compare differences between the two groups, the analysis of covariance was utilized. All statistical significance levels were set at ${\alpha}=0.05$. Results: There were significant differences before and after the intervention within both groups in changes of 10MWT, 6MWT, and TUG (p<0.01). Regarding differences between the two groups, the experimental group underwent more effective changes than the control group in 6MWT and TUG (p<0.05). Conclusion: This study applied PNF lower leg taping and treadmill training to patients with hemiplegia resulting from a stroke, and this resulted in improvement in the subjects' gait and balance abilities. Taping and treadmill training based on the PNF concept is considered to be usefully applied as one of the programs to improve hemiplegic patients' gait and balance abilities.
PURPOSE: This study examined the effects of treadmill training with taping on the affected ankle joint on the gait and balancing ability in patients with sub-acute stroke. METHODS: Nineteen patients with sub-acute hemiplegic stroke in a rehabilitation hospital were assigned randomly to either the experimental group (n = 10), who received treadmill training with taping on the affected ankle joint or the control group (n = 9), who received general treadmill training. All participants performed 60 min of comprehensive rehabilitation therapy (five sessions per week for four weeks). Each group received treadmill training with or without taping on the affected ankle joint for 20 min (three sessions per week for four weeks). The gait and balancing ability were measured before and after the four-week training. RESULTS: Post-training scores of 10-meter walk test (10 MWT), timed up and go (TUG) test, and center of pressure (COP) path length and velocity for the experimental group increased significantly compared to that pre-training (p < .05). The experimental group showed a larger decrease in the 10 MWT and TUG test than the control group (-3.5 s vs. -1.01 s, p < .05; -4.9 s vs. -1.7 s, p < .05; respectively) CONCLUSION: Treadmill training with taping on the affected ankle joint might improve the gait and balancing ability of stroke patients and is considered a more effective method for improving gait and balancing ability than the method of general treadmill training.
The purpose of this study was to determine the therapeutic effect of slope changes of the treadmill with body weight-supported training on gait characteristics in patients with hemiplegia. The volunteered subjects were divided into 3 groups based upon slope changes: control group ($0^{\circ}$ incline), $7^{\circ}$ group ($7^{\circ}$ incline), $12^{\circ}$ group ($12^{\circ}$ incline), They were trained the body weight-supported treadmill training (BWSTT) for 8 weeks. All subjects were supported up to 40% of their body weight on the treadmill training and the support was gradually decreased to 0~10% as the subjects were adapted to the training. There were significant improvements of walking velocity, step length of the affected side, the asymmetry ratio of step length in $7^{\circ}$ group (57.80 cm/s, 67.25 cm, .14), $12^{\circ}$ group (71.00 cm/s, 71.00 cm, .11) than control group (40.62 cm/s, 55.00 cm, .74) (p<.05): there were no differences between $7^{\circ}$ group and $12^{\circ}$ group in the all outcomes (p>.05). Both $7^{\circ}$ group and $12^{\circ}$ group scored higher than the control group in those outcomes and finally the effects of slopes changes of the treadmill were effective on gait characteristics of patients. But it s till remains undetermined what degree on the treadmill might be better to train the hemipareric patients. Therefore, more studies are required to look into minutely the changes of slopes of the treadmill influencing on gait characteristics.
Purpose: This study aimed to analyze the visual and spatial elements of the gait of a stroke patient who had diverse ankle weight loads applied, according to weight changes. Methods: The subject was a 57-year-old stroke patient diagnosed and hospitalized with a left intracerebral hemorrhage. A weight equivalent to 0%, 1%, and 2% of his body weight was applied to the area 5cm upward from the ankle using a Velcro strap. He was then trained on a treadmill, receiving a six-minute walk test to evaluate his gait ability. A gait analyzer was used to collect visual and spatial elements, such as gait distance, gait velocity, cadence, step length, stride length, and swing phase, according to a weight load equivalent to 0%, 1%, and 2% of his body weight. Results: According to the results of applying 0%, 1%, and 2% of his body weight on the ankle, except for gait velocity, his gait distance, cadence, step length, stride length, and swing phase were higher when 1% of his body weight was applied compared to 0% or 2% of his body weight. Conclusion: Applying a weight equivalent to 1% of the body weight to the ankle positively affected the visual and spatial element of the gait and heightened the efficiency of exercise during treadmill training, a gait-training tool generally used for stroke patients. However, the result is difficult to generalize because the number of subjects was small with only one subject.
Objective: In the present study, the effects of progressive body weight support treadmill forward & backward walking training (FBWT), progressive body weight support treadmill forward walking training (FWT), and progressive body weight support treadmill backward walking training (BWT), and on stroke patients' ambulatory abilities were examined. Design: Randomized controlled trial. Methods: A total of 36 chronic stroke patients were divided into three groups with 12 subjects in each group. Each of the groups performed one of the progressive body weight supported treadmill training methods for 30 minute, six times per week for three weeks, and then received general physical therapy without any other intervention until the follow-up tests. For the assessment of the step length, total double support, cadence, gait were measured using optogait and the 10-m walk test (10MWT), 6 minutes walk test (6MWT). Results: In the within group comparisons, all the three groups showed significant differences between before and after the intervention (p<0.05). In the comparison of the three groups, there were significant differences among the three groups in stride length, double limb support stance, cadence, 10MWT, and 6MWT in the third week, and only in stride length, 10MWT, and 6MWT test in the sixth week (p<0.05). Conclusions: This study verified that progressive body weight-supported treadmill gait training positively affected the gait ability of stroke patients in an actual gait environment. It also showed that FBWT group was more effective than FWT group and BWT group training.
Objective: To confirm the immediate gait improvement in a post-stroke gait disturbance patient equipped with a weighted vest. Methods: We selected a patient who was able to walk without another’s help or with tools. The selected patient had an unstable gait because she had only started an independent gait within the past week, so we thought that a weighted vest could be very helpful for her. We first collected gait parameters using a treadmill gait analysis system while the patient walked on the treadmill without the weighted vest. After a 10-minute break, gait parameters were collected again while the patient walked on the treadmill while wearing the weighted vest. The gait parameters we collected included step length (cm), stance phase (%), swing phase (%), SW/ST, and gait line length (mm). For objective evaluation of gait improvement, we calculated the ratio of gait parameters of the right and left limbs. Results: The gait of the post-stroke patient was more symmetrical when wearing the weighted vest than without the weighted vest. Without the weighted vest, her step length ratio was 0.78, stance phase ratio was 0.88, swing phase ratio was 1.50, SW/ST ratio was 1.70, and gait line length ratio was 0.91. With the weighted vest, her step length ratio was 0.88, stance phase ratio was 0.90, swing phase ratio was 1.38, SW/ST ratio was 1.54, and gait line length ratio was 0.98. No side effects were observed due to the weighted vest.
Purpose: The purpose of this study was to examine the influence of a handrail (presence and position) on treadmill gait and balance in stroke patients during gait training. Methods: 39 patients with stroke (male 31, female 8) participated in this study. The training groups were classified into a no-handrail group (NHG), front handrail group (FHG), and bilateral handrail group (BHG). Each group comprised 13 subjects. The subjects were trained to walk in a straight path 30 minutes per day for 8 weeks. The Good Balance System was used to measure static balance and dynamic balance. To measure walking ability, timed up and go (TUG) was also assessed. Results: The NHG showed no significant differences in static balance, dynamic balance, and TUG. The FHG was significantly different in their medial-lateral speed of static balance, dynamic balance, and TUG. The BHG was significantly different in their static balance, dynamic balance, and TUG. Conclusion: These findings consider the effects of holding handrails concomitantly with changes in postural stability. We conclude that for training stroke patients, treadmill walking while holding handrails improves balance and gait more than treadmill walking without holding handrails. The resulting changes in muscle activity patterns may facilitate the transfer to a gait pattern. The results of this study suggest methods for training treadmill walking in stroke patients.
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