Treadmill walking with partial body weight support versus floor walking in hemiparetic subjects

Hesse, Stefan; Konrad, M.; Uhlenbrock, Dietmar

doi:10.1016/s0003-9993(99)90279-4

Cited by 264 publications

(196 citation statements)

References 19 publications

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“…The transfer of improved gait quality during treadmill training to walking on the floor has yet to be demonstrated. 24 Our patients' gait parameters, however, were recorded while they were walking on the floor. This result is even more interesting because the gait parameter have been evaluated by a blinded observer.…”

Section: Discussionmentioning

confidence: 99%

Effects of Locomotion Training With Assistance of a Robot-Driven Gait Orthosis in Hemiparetic Patients After Stroke

Husemann

Müller

Krewer

et al. 2007

Stroke

371

271

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Background and Purpose-The success of gait rehabilitation after stroke depends on active walking exercises. However, the disabling after-effects of stroke often make such exercises impossible at the onset of therapy. To facilitate treadmill training of paraparetic patients, a robot-driven gait orthosis (Lokomat) was developed. We investigated the effects of the Lokomat when used with hemiparetic patients. Methods-The authors conducted a randomized, controlled pilot study of 30 acute stroke survivors. The treatment group received 30 minutes of robotic training daily and the control group 30 minutes of conventional physiotherapy daily in addition to 30 minutes of conventional physiotherapy for each group. Outcome measures were independence of gait, gait speed, gait parameters, and body tissue composition. Results-After 4 weeks of therapy, the walking ability of the Lokomat group and the control group expressed as the functional ambulation classification was significantly improved. The functional ambulation category (medianϮ interquartile range) was at baseline 0Ϯ0 in control and 0Ϯ1 in the therapy group and increased after therapy to 1Ϯ3 in both groups significantly (Pϭ0.01). There was no significant difference in gain of these parameters between the groups. The Lokomat group had a significantly longer single stance phase (sec; meanϮSEM) on the paretic leg when walking on the floor. At baseline, it was 0.19Ϯ0.17 and after therapy 0.49Ϯ0.07 (Pϭ0.014). The control group had increased their body weight approximately 1.33Ϯ1.40 kg (meanϮSEM; Pϭ0.046), mostly as fat mass, whereas the Lokomat group had lost fat mass approximately Ϫ2.9Ϯ1.0 kg (meanϮSEM; Pϭ0.016) and increased their muscle mass approximately 3.36Ϯ1.4 kg (meanϮ SEM; Pϭ0.031). Conclusions-This pilot study indicates that Lokomat therapy is a promising intervention for gait rehabilitation. Although there was no difference between groups in gain of functional scores, the Lokomat group showed an advantage of robotic training over conventional physiotherapy in improvement of gait abnormality and body tissue composition. (Stroke.

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Section: Discussionmentioning

confidence: 99%

Effects of Locomotion Training With Assistance of a Robot-Driven Gait Orthosis in Hemiparetic Patients After Stroke

Husemann

Müller

Krewer

et al. 2007

Stroke

371

271

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“…As a result, gait speed is decreased, and due to inappro- 19,20 For this reason, recently various rehabilitation programs are being applied to recover the function and walking ability of stroke patients. In the study by Hesse et al, 8 it was found that partial weight support treadmill training increased the ratio of symmetrical stance and swing phase in the affected and non-affected side according to the increase of ratio of single limb standing and swing phase.…”

Section: Discussionmentioning

confidence: 95%

“…7 Previous study on underwater gait crease in the cycle of asymmetric gait, as well as a balanced gait pattern. 8 A study that applied additional weight onto the affected side single limb reported that by minimizing the tendency of the affected side lower limb to float on water, it increased the stability of the stance phase and resulted in increasing the lower limb strength due to applying additional weight. As a result, study reported that weight-bearing was more effective, there was an increase in affected side lower limb percentage and an increase in the swing phase of non-affected side lower limb.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Underwater Gait Training with Additional Weight Application and Over-ground Gait Training to Improve Balance and Lower Extremity Strength in Persons with Stroke

Park

Chung

2017

J Kor Phys Ther

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Purpose: This purpose of this study was to compare additionally applied weight underwater gait training and over-ground gait training to improve balance and lower extremity strength in stroke patients. Methods: Subjects were randomly allocated into two groups. Underwater gait training group (n = 10) and Over-ground gait training group (n= 9). The groups performed their respective programs as well as conventional physical therapy 3 times/week for 6 weeks. All subjects were assessed with the Berg balance scale test, the timed up and go test, and the medical research council test pre and post intervention. A paired t test was applied to compare the differences before and after the intervention, and an independent t test was used to compare the differences between the groups. The level of statistical significance was set at p< 0.05. Results:The results showed that subjects in the underwater gait training group had a significantly increased Berg balance scale, timed up and go, and medical research council scores (p< 0.05), and over-ground gait training group showed a significantly increased medical research council score (p< 0.05) after intervention. The underwater gait training group showed a more significant improvement in medical research council, Berg balance scale and the timed up and go test scores compared to the over-ground gait training group (p< 0.05). Conclusion: Findings of this study suggest that applying additional weight during underwater gait training improves lower extremity strength and balance in stroke patients. It' findings can contribute to the development of more efficient rehabilitation for stroke patients.

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“…It has been recognized that partial body weight support with the loading of weight on the hind feet is important for locomotor training. 8,16 Sensory inputs were reported to be important in the body weight-supported treadmill training of patients. 17 Dietz et al 7 reported that afferent inputs from hip joints and inputs from load receptors had a crucial role in the generation of locomotor activity in the presence of complete para/tetraplegia of the human spinal cord.…”

Section: Central Pattern Generatormentioning

confidence: 99%

Locomotor improvement of spinal cord-injured rats through treadmill training by forced plantar placement of hind paws

et al. 2015

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Study design: Experimental training model of rats with spinal cord injury (SCI).Setting: Osaka, Japan Objective: To investigate the effect of forced treadmill training by plantar placement (PP), as compared with dorsal placement (DP), of the dorsal paws on the locomotor behaviors of spinal cord-injured rats. Methods: The spinal cord was contusion-injured at the thoracic level. Rats were divided into three groups: forced training involving stepping by PP and DP and non-forced training/assistance (nT). Training began 1 week after injury and was conducted for 4 weeks. Locomotor behaviors were estimated using Basso-Beattie-Bresnahan (BBB) scores, dorsiflexion of the hind paws and footprints of the hind paws. Histological and immunohistochemical examinations of the spinal cord lesions were conducted after 4 weeks of training. Results: The values, respectively, of PP, DP and nT groups at 4 weeks of training were as follows: BBB scores were 15.6 ± 0.8, 7.7 ± 1.3 and 10.3 ± 0.4. The paw dorsiflexion angles were 34.1 ± 5.2, 16.4 ± 2.4 and 23.6 ± 3.0 degrees, respectively. The stride angles were 5.1 ± 0.9, 13.7 ± 4.9 and 17.8 ± 4.0 degrees for the left paws. Cavity volumes were 10.3 ± 2.1, 31.0 ± 2.0 and 28.2 ± 4.9%. In addition to cavities, there were astrocyte-devoid areas containing some loose tissues, through which many axons extended longitudinally. Conclusions: The BBB score, dorsiflexion angle and stride angle were consistently improved in the PP group. Cavity formation was more reduced, and many axons extended through coarse tissues formed in astrocyte-devoid areas at the lesion in the PP group. INTRODUCTIONSpinal cord injury (SCI) is devastating; patients with SCI lose functions below the level of the injury, and recovery of the locomotor functions is limited even with extensive rehabilitation. Body weight support treadmill (BWST) training with plantar stepping is widely used for locomotor exercises in the rehabilitation of patients with SCI. However, the effectiveness of plantar stepping of the hind feet has not been fully evaluated experimentally. The present study focused on the effect of forced treadmill training by plantar placement (PP) of the hind paws on the locomotor behaviors of rats with SCI. Recent cell transplantation studies have reported the recovery of injured spinal cord tissue and the behavioral improvement of SCI animals. 1 Our previous studies showed that bone marrow stromal cell transplantation is effective for locomotor recovery from SCI in rats, 2 findings that have been applied to clinical cases. 3 Along with the emergence of potentially effective treatments of SCI, including cell transplantation therapy, hope for the rehabilitation of patients with SCI has increased. It is now all the more important to experimentally explore the effects of rehabilitation on recovery from SCI.

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Treadmill walking with partial body weight support versus floor walking in hemiparetic subjects

Cited by 264 publications

References 19 publications

Effects of Locomotion Training With Assistance of a Robot-Driven Gait Orthosis in Hemiparetic Patients After Stroke

Effects of Locomotion Training With Assistance of a Robot-Driven Gait Orthosis in Hemiparetic Patients After Stroke

A Comparison of Underwater Gait Training with Additional Weight Application and Over-ground Gait Training to Improve Balance and Lower Extremity Strength in Persons with Stroke

Locomotor improvement of spinal cord-injured rats through treadmill training by forced plantar placement of hind paws

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