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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

Comparisons between walking speed (A, B, C), average step length (D, E, F), and average cadence (G, H, I) during overground, “push mode”, and treadmill walking at three different speeds. Each column represents mean value ± SEM. Asterisks indicate significant difference (p<0.05) when compared to the other two walking conditions.
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Figure 2: Comparisons between walking speed (A, B, C), average step length (D, E, F), and average cadence (G, H, I) during overground, “push mode”, and treadmill walking at three different speeds. Each column represents mean value ± SEM. Asterisks indicate significant difference (p<0.05) when compared to the other two walking conditions.

Mentions: Stroke survivors reached significantly faster speeds in the “push mode” (1.92 ± 0.06 m/s) than on the treadmill (1.67 ± 0.11 m/s) (p<0.05) and both were faster than overground (1.19 ± 0.09 m/s) (p<0.05), as seen in Figure 2C. Figure 2C,2F, and2I show the walking speed, average step length and average cadence achieved by participants during the top walking speed (TWS). The average step lengths at TWS were similar in the three conditions. However, the average cadence at TMS showed statistically significant differences between conditions, i. e. cadence in the “push mode” (3.53 ± 0.22 steps/s) was significantly faster than in the treadmill (2.74 ± 0.19 steps/s; p<0.05) and both were faster than overground (1.89 ± 0.08 steps/s; p<0.05).


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)

Comparisons between walking speed (A, B, C), average step length (D, E, F), and average cadence (G, H, I) during overground, “push mode”, and treadmill walking at three different speeds. Each column represents mean value ± SEM. Asterisks indicate significant difference (p<0.05) when compared to the other two walking conditions.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Comparisons between walking speed (A, B, C), average step length (D, E, F), and average cadence (G, H, I) during overground, “push mode”, and treadmill walking at three different speeds. Each column represents mean value ± SEM. Asterisks indicate significant difference (p<0.05) when compared to the other two walking conditions.
Mentions: Stroke survivors reached significantly faster speeds in the “push mode” (1.92 ± 0.06 m/s) than on the treadmill (1.67 ± 0.11 m/s) (p<0.05) and both were faster than overground (1.19 ± 0.09 m/s) (p<0.05), as seen in Figure 2C. Figure 2C,2F, and2I show the walking speed, average step length and average cadence achieved by participants during the top walking speed (TWS). The average step lengths at TWS were similar in the three conditions. However, the average cadence at TMS showed statistically significant differences between conditions, i. e. cadence in the “push mode” (3.53 ± 0.22 steps/s) was significantly faster than in the treadmill (2.74 ± 0.19 steps/s; p<0.05) and both were faster than overground (1.89 ± 0.08 steps/s; p<0.05).

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