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Maximum walking speeds obtained using treadmill and overground robot system in persons with post-stroke hemiplegia.

Capó-Lugo CE, Mullens CH, Brown DA - J Neuroeng Rehabil (2012)

Bottom Line: Subjects achieved these faster speeds by initially increasing both step length and cadence and, once individuals stopped increasing their step length, by only increasing cadence.With post-stroke hemiplegia, individuals are able to walk at faster speeds than their SMWS overground, when provided with a safe environment that provides external forces that requires them to attempt dynamic stability maintenance at higher gait speeds.Therefore, this study suggests the possibility that, given the appropriate conditions, people post-stroke can be trained at higher speeds than previously attempted.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL 60611, USA. carmen.capo@u.northwestern.edu

ABSTRACT

Background: Previous studies demonstrated that stroke survivors have a limited capacity to increase their walking speeds beyond their self-selected maximum walking speed (SMWS). The purpose of this study was to determine the capacity of stroke survivors to reach faster speeds than their SMWS while walking on a treadmill belt or while being pushed by a robotic system (i.e. "push mode").

Methods: Eighteen chronic stroke survivors with hemiplegia were involved in the study. We calculated their self-selected comfortable walking speed (SCWS) and SMWS overground using a 5-meter walk test (5-MWT). Then, they were exposed to walking at increased speeds, on a treadmill and while in "push mode" in an overground robotic device, the KineAssist, until they were tested at a speed that they could not sustain without losing balance. We recorded the time and number of steps during each trial and calculated gait speed, average cadence and average step length.

Results: Maximum walking speed in the "push mode" was 13% higher than the maximum walking speed on the treadmill and both were higher ("push mode": 61%; treadmill: 40%) than the maximum walking speed overground. Subjects achieved these faster speeds by initially increasing both step length and cadence and, once individuals stopped increasing their step length, by only increasing cadence.

Conclusions: With post-stroke hemiplegia, individuals are able to walk at faster speeds than their SMWS overground, when provided with a safe environment that provides external forces that requires them to attempt dynamic stability maintenance at higher gait speeds. Therefore, this study suggests the possibility that, given the appropriate conditions, people post-stroke can be trained at higher speeds than previously attempted.

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Related in: MedlinePlus

Overground robotic gait and balance system (KineAssistTM) use to provide external forces at the pelvis during walking (i.e. “push mode” walking).
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Figure 1: Overground robotic gait and balance system (KineAssistTM) use to provide external forces at the pelvis during walking (i.e. “push mode” walking).

Mentions: While a motorized treadmill has been shown to be successful in assisting individuals post-stroke to walk at higher speeds, we sought to test a new robotic system, the KineAssist Walking and Balance Training System (Figure 1), which has the possibility of “pushing” individuals to walk at very high overground speeds and, yet, provide safety in the event of a sudden trip or fall[31,32]. Trips or falls are expected to occur at very high speeds in people post-stroke so this safety mechanism, a pelvic harness system that detects when the pelvis has dropped a certain threshold height, is critical for the study of maximum walking speed capability post-stroke. Also, when the KineAssist is in the “push mode”, it will assist the person to move across the walking surface at very high speeds (up to 2.0 m/s).


Maximum walking speeds obtained using treadmill and overground robot system in persons with post-stroke hemiplegia.

Capó-Lugo CE, Mullens CH, Brown DA - J Neuroeng Rehabil (2012)

Overground robotic gait and balance system (KineAssistTM) use to provide external forces at the pelvis during walking (i.e. “push mode” walking).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539927&req=5

Figure 1: Overground robotic gait and balance system (KineAssistTM) use to provide external forces at the pelvis during walking (i.e. “push mode” walking).
Mentions: While a motorized treadmill has been shown to be successful in assisting individuals post-stroke to walk at higher speeds, we sought to test a new robotic system, the KineAssist Walking and Balance Training System (Figure 1), which has the possibility of “pushing” individuals to walk at very high overground speeds and, yet, provide safety in the event of a sudden trip or fall[31,32]. Trips or falls are expected to occur at very high speeds in people post-stroke so this safety mechanism, a pelvic harness system that detects when the pelvis has dropped a certain threshold height, is critical for the study of maximum walking speed capability post-stroke. Also, when the KineAssist is in the “push mode”, it will assist the person to move across the walking surface at very high speeds (up to 2.0 m/s).

Bottom Line: Subjects achieved these faster speeds by initially increasing both step length and cadence and, once individuals stopped increasing their step length, by only increasing cadence.With post-stroke hemiplegia, individuals are able to walk at faster speeds than their SMWS overground, when provided with a safe environment that provides external forces that requires them to attempt dynamic stability maintenance at higher gait speeds.Therefore, this study suggests the possibility that, given the appropriate conditions, people post-stroke can be trained at higher speeds than previously attempted.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL 60611, USA. carmen.capo@u.northwestern.edu

ABSTRACT

Background: Previous studies demonstrated that stroke survivors have a limited capacity to increase their walking speeds beyond their self-selected maximum walking speed (SMWS). The purpose of this study was to determine the capacity of stroke survivors to reach faster speeds than their SMWS while walking on a treadmill belt or while being pushed by a robotic system (i.e. "push mode").

Methods: Eighteen chronic stroke survivors with hemiplegia were involved in the study. We calculated their self-selected comfortable walking speed (SCWS) and SMWS overground using a 5-meter walk test (5-MWT). Then, they were exposed to walking at increased speeds, on a treadmill and while in "push mode" in an overground robotic device, the KineAssist, until they were tested at a speed that they could not sustain without losing balance. We recorded the time and number of steps during each trial and calculated gait speed, average cadence and average step length.

Results: Maximum walking speed in the "push mode" was 13% higher than the maximum walking speed on the treadmill and both were higher ("push mode": 61%; treadmill: 40%) than the maximum walking speed overground. Subjects achieved these faster speeds by initially increasing both step length and cadence and, once individuals stopped increasing their step length, by only increasing cadence.

Conclusions: With post-stroke hemiplegia, individuals are able to walk at faster speeds than their SMWS overground, when provided with a safe environment that provides external forces that requires them to attempt dynamic stability maintenance at higher gait speeds. Therefore, this study suggests the possibility that, given the appropriate conditions, people post-stroke can be trained at higher speeds than previously attempted.

Show MeSH
Related in: MedlinePlus