Rehabilitation of Walking After Stroke

Bowden, Mark G.; Embry, Aaron E.; Perry, Lindsay; Duncan, Pamela W.

doi:10.1007/s11940-012-0198-1

Cited by 12 publications

(7 citation statements)

References 50 publications

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“…The ability to walk unaided plays a major role in people’s independence, quality of life, and participation in society ( Schmid et al, 2007 ). It is often impaired by musculoskeletal or neurological conditions or diseases such as osteoarthritis, balance disorders, multiple sclerosis, a stroke, or cerebral palsy ( Bowden et al, 2012 ; Patterson et al, 2012a ; Routson et al, 2013 ). Regaining or improving the ability to walk is a primary occupation for these patients ( Bohannon et al, 1988 ; Bowden et al, 2012 ; Gordon et al, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

“…It is often impaired by musculoskeletal or neurological conditions or diseases such as osteoarthritis, balance disorders, multiple sclerosis, a stroke, or cerebral palsy ( Bowden et al, 2012 ; Patterson et al, 2012a ; Routson et al, 2013 ). Regaining or improving the ability to walk is a primary occupation for these patients ( Bohannon et al, 1988 ; Bowden et al, 2012 ; Gordon et al, 2013 ). Rehabilitation exercises are mainly carried out on dry-land, although, it has become common practice to use exercises with the body partly submerged in water ( Prins and Cutner, 1999 ), typically to the level of the xiphoid process ( Denning et al, 2010 ; Masumoto et al, 2007a ).…”

Section: Introductionmentioning

confidence: 99%

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Kinematic Adaptations of Forward and Backward Walking on Land and in Water

Cadenas‐Sanchez

Arellano

Vanrenterghem

et al. 2015

Journal of Human Kinetics

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The aim of this study was to compare sagittal plane lower limb kinematics during walking on land and submerged to the hip in water. Eight healthy adults (age 22.1 ± 1.1 years, body height 174.8 ± 7.1 cm, body mass 63.4 ± 6.2 kg) were asked to cover a distance of 10 m at comfortable speed with controlled step frequency, walking forward or backward. Sagittal plane lower limb kinematics were obtained from three dimensional video analysis to compare spatiotemporal gait parameters and joint angles at selected events using two-way repeated measures ANOVA. Key findings were a reduced walking speed, stride length, step length and a support phase in water, and step length asymmetry was higher compared to the land condition (p<0.05). At initial contact, knees and hips were more flexed during walking forward in water, whilst, ankles were more dorsiflexed during walking backward in water. At final stance, knees and ankles were more flexed during forward walking, whilst the hip was more flexed during backward walking. These results show how walking in water differs from walking on land, and provide valuable insights into the development and prescription of rehabilitation and training programs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Kinematic Adaptations of Forward and Backward Walking on Land and in Water

Cadenas‐Sanchez

Arellano

Vanrenterghem

et al. 2015

Journal of Human Kinetics

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“…One of the main causes of disability after stroke is upper extremity weakness that limits performance of activities of daily living (eg, feeding and self‐care) as well as broader engagement in society . However, lower extremity weakness, spasticity, pain, dysphagia, dysarthria, aphasia, visual field deficits, depression, and cognitive deficits can also limit activities and access to the broader community …”

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confidence: 99%

Neurorehabilitation: Motor recovery after stroke as an example

Ganguly

Byl

Abrams

2013

Annals of Neurology

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The field of neurorehabilitation aims to translate neuroscience research toward the goal of maximizing functional recovery after neurological injury. A growing body of research indicates that the fundamental principles of neurological rehabilitation are applicable to a broad range of congenital, degenerative, and acquired neurological disorders. In this perspective, we will focus on motor recovery after acquired brain injuries such as stroke. Over the past few decades, a large body of basic and clinical research has created an experimental and theoretical foundation for approaches to neurorehabilitation. Recent randomized clinical trials all emphasize the requirement for intense progressive rehabilitation programs to optimally enhance recovery. Moreover, advances in multimodal assessment of patients with neuroimaging and neurophysiological tools suggest the possibility of individualized treatment plans based on recovery potential. There are also promising indications for medical as well as noninvasive brain stimulation paradigms to facilitate recovery. Ongoing or planned clinical studies should provide more definitive evidence. We also highlight unmet needs and potential areas of research. Continued research built upon a robust experimental and theoretical foundation should help to develop novel treatments to improve recovery after neurological injury.

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“…2 Impaired locomotion restricts a person after stroke from both performing mobility activities and participating in vocational and avocational activities. To rehabilitate post-stroke walking impairments, rehabilitation strategies 3 have been developed to improve walking function and to promote greater participation in social activities. Yet, neither behavioral treatments, such as treadmill training, nor neurophysiological interventions, such as functional electrical stimulation, are capable of fully restoring walking to pre-stroke levels.…”

Section: Introductionmentioning

confidence: 99%

Motor Cortex and Motor Cortical Interhemispheric Communication in Walking After Stroke

Charalambous

Bowden

Adkins

2015

Neurorehabil Neural Repair

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Despite the plethora of human neurophysiological research, the bilateral involvement of the leg motor cortical areas and their interhemispheric interaction during both normal and impaired human walking is poorly understood. Using transcranial magnetic stimulation (TMS), we have expanded our understanding of the role upper-extremity motor cortical areas play in normal movements and how stroke alters this role, and probe the efficacy of interventions to improve post-stroke arm function. However, similar investigations of the legs have lagged behind, in part, due to the anatomical difficulty in using TMS to stimulate the leg motor cortical areas. Additionally, leg movements are predominately bilaterally controlled and require interlimb coordination that may involve both hemispheres. The sensitive, but invasive, tools used in animal models of locomotion hold great potential for increasing our understanding of the bihemispheric motor cortical control of walking. In this review, we discuss three themes associated with the bihemispheric motor cortical control of walking after stroke: 1) what is known about the role of the bihemispheric motor cortical control in healthy and post-stroke leg movements, 2) how the neural remodeling of the contralesional hemisphere can affect walking recovery after a stroke, and 3) what is the effect of behavioral rehabilitation training of walking on the neural remodeling of the motor cortical areas bilaterally. For each theme, we discuss how rodent models can enhance the present knowledge on human walking by testing hypotheses that cannot be investigated in humans, and how these findings can then be back-translated into the neurorehabilitation of post-stroke walking.

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Rehabilitation of Walking After Stroke

Cited by 12 publications

References 50 publications

Kinematic Adaptations of Forward and Backward Walking on Land and in Water

Kinematic Adaptations of Forward and Backward Walking on Land and in Water

Neurorehabilitation: Motor recovery after stroke as an example

Motor Cortex and Motor Cortical Interhemispheric Communication in Walking After Stroke

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