Cerebrovascular Accident Clinical Trial
Official title:
Ground-level Partial Body Weight Support Gait Training for Individuals With Chronic Stroke
The purpose of this study was to investigate the effects of gait training on ground level with partial body weight support (BWS)in individuals with stroke during overground walking with no BWS.
Individuals were mechanically supported on a BWS system as they walked on ground level. All
individuals started the training with 30% of body weight unloading and after three weeks,
this percentage was reduced to 20% for the remainder of the six-week training period. The
criterion used to reduce the percentage of BWS was the individual's ability to maintain
alignment of the trunk and to transfer the weight to and from the paretic limb during gait.
Individuals' body mass was measured weekly to ensure the appropriate percentage of body
weight unloading.
During the training sessions, a physical therapist encouraged the individuals to walk as
fast as possible, and feedback was provided in order to improve gait performance, such as
vertical alignment of the trunk, symmetric limb weight distribution, and proper movement of
the lower limbs. Heart rate and blood pressure were observed at beginning and end of each
session, and when the patients reported any symptoms of discomfort during the session. Rest
periods were allowed during the training sessions according to individual need.
All individuals were submitted to gait training sessions of 45 minutes, three times a week,
on alternating day during six weeks, completing a total of 18 sessions. None of them were
given any other type of physical intervention or conventional gait training, stretching,
muscle strengthening or endurance exercise while participating in this study.
In order to verify the effects of the described gait training, individuals were assessed
before and after gait training program, walking freely at self-selected comfortable speed
along a 10 m walkway six times. They were videotaped by four digital cameras (AG-DVC7P,
Panasonic) at 60 Hz, which were positioned bilaterally in order to allow simultaneous
kinematics measurement of paretic and nonparetic limbs in either direction of motion (from
left to right and vice-versa). During the evaluation, individuals were not allowed to use
any assistive device, and they walked with the physical therapists' assistance to keep
balance, when necessary.
Passive reflective markers were placed on the nonparetic and paretic sides of the body at
the following anatomical locations: head of the fifth metatarsal, lateral malleolus, lateral
epicondyle of the femur, greater trochanter, and acromion, in order to define the foot,
shank, thigh, and trunk segments, respectively. The digitalization and the reconstruction of
all markers were performed using Ariel Performance Analysis System - APAS (Ariel Dynamics,
Inc.) software, and filtering and posterior analyses were performed using Matlab software
(MathWorks, Inc. - Version 6.5). Reconstruction of the real coordinates was performed using
the direct linear transformation (DLT) procedure.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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