Spatiotemporalgait analysis can provide quantitative information to assess treatment outcomes in stroke survivors. Therefore, clinicians need a portable, easy-to-use and low-cost tool, which accurately and reliably measures spatiotemporal gait parameters. This study examined the concurrent validity and reproducibility of the Gait Up© gait analysis package for spatiotemporal gait analysis in subacute stroke survivors. Twenty-five subacute stroke survivors participated in 2 walking tests. Spatiotemporal gait parameters were synchronously measured by 2 foot-worn inertial sensors (Physilog®) and three-dimensional motion capturing (Vicon). Intraclass correlation coefficients, standard errors of measurement, smallest detectable changes, limits of agreement and Bland-Altman plots were calculated for the paretic and nonparetic side. After removing a consistent outlier (i.e. data of the paretic side of subject 36 who dragged his foot), agreement between both devices was good to excellent for paretic and nonparetic gait cycle time, cadence, stride length, stride velocity and double support; and moderate for paretic and non-paretic stance and swing. Bland-Altman plots supported these findings. Testretest reliability was good to excellent for most parameters, except paretic stance and swing. In conclusion, the Gait Up© gait analysis package is a valid and reliable tool to measure paretic and nonparetic gait cycle time, cadence, stride length and stride velocity in subacute patients with stroke, who don't exhibit severe dragging of the paretic foot. However, the algorithm should be improved for the analysis of paretic stance and swing phase.
We describe a 33-year-old woman with chronic bulbar dysarthria after ischemic brainstem stroke who underwent a new form of constraint-induced therapy, namely constraint-induced dysarthria therapy, based on three principles: avoidance of supportive devices, intensive therapy, and gradually augmenting difficulty. After a 2-month intervention, improvement was noted for speech intelligibility, fluency, and intensity. This led to increased communicative participation, including during conversation situations, which has been maintained over a 12-month follow-up.
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