The use of body weight support on ground level: an alternative strategy for gait training of individuals with stroke

<p>Abstract</p> <p>Background</p> <p>Body weight support (BWS) systems on treadmill have been proposed as a strategy for gait training of subjects with stroke. Considering that ground level is the most common locomotion surface and that there is little information about individuals with stroke walking with BWS on ground level, it is important to investigate the use of BWS on ground level in these individuals as a possible alternative strategy for gait training.</p> <p>Methods</p> <p>Thirteen individuals with chronic stroke (four women and nine men; mean age 54.46 years) were videotaped walking on ground level in three experimental conditions: with no harness, with harness bearing full body weight, and with harness bearing 30% of full body weight. Measurements were recorded for mean walking speed, cadence, stride length, stride speed, durations of initial and terminal double stance, single limb support, swing period, and range of motion of ankle, knee, and hip joints; and foot, shank, thigh, and trunk segments.</p> <p>Results</p> <p>The use of BWS system leads to changes in stride length and speed, but not in stance and swing period duration. Only the hip joint was influenced by the BWS system in the 30% BWS condition. Shank and thigh segments presented less range of motion in the 30% BWS condition than in the other conditions, and the trunk was held straighter in the 30% BWS condition than in the other conditions.</p> <p>Conclusion</p> <p>Individuals with stroke using BWS system on ground level walked slower and with shorter stride length than with no harness. BWS also led to reduction of hip, shank, and thigh range of motion. However, this system did not change walking temporal organization and body side asymmetry of individuals with stroke. On the other hand, the BWS system enabled individuals with chronic stroke to walk safely and without physical assistance. In interventions, the physical therapist can watch and correct gait pattern in patients' performance without the need to provide physical assistance.</p

Gait training with partial body weight support during overground walking for individuals with chronic stroke: a pilot study

<p>Abstract</p> <p>Background</p> <p>It is not yet established if the use of body weight support (BWS) systems for gait training is effective <it>per se </it>or if it is the combination of BWS and treadmill that improves the locomotion of individuals with gait impairment. This study investigated the effects of gait training on ground level with partial BWS in individuals with stroke during overground walking with no BWS.</p> <p>Methods</p> <p>Twelve individuals with chronic stroke (53.17 ± 7.52 years old) participated of a gait training program with BWS during overground walking, and were evaluated before and after the gait training period. In both evaluations, individuals were videotaped walking at a self-selected comfortable speed with no BWS. Measurements were obtained for mean walking speed, step length, stride length and speed, toe-clearance, durations of total double stance and single-limb support, and minimum and maximum foot, shank, thigh, and trunk segmental angles.</p> <p>Results</p> <p>After gait training, individuals walked faster, with symmetrical steps, longer and faster strides, and increased toe-clearance. Also, they displayed increased rotation of foot, shank, thigh, and trunk segmental angles on both sides of the body. However, the duration of single-limb support remained asymmetrical between each side of the body after gait training.</p> <p>Conclusions</p> <p>Gait training individuals with chronic stroke with BWS during overground walking improved walking in terms of temporal-spatial parameters and segmental angles. This training strategy might be adopted as a safe, specific and promising strategy for gait rehabilitation after stroke.</p

Effects of isokinetic eccentric training on knee extensor and flexor torque and on gait of individuals with long term ACL reconstruction: A controlled clinical trial

Abstract-This study investigated the effects of the isokinetic eccentric training (IET) on the knee extensor and flexor torque and kinematic gait parameters in individuals with ACL reconstruction. Sixteen men with ACL reconstructed (ACLr) whose torque and the gait were evaluated, before and after 12 weeks of IET, was compared to a control group (14 individuals). Student t, MANOVA and ANOVA tests were performed with 5% of significance. The training increased the isometric, concentric at 30 and 120º/s (p &lt; .05) and eccentric at 30º/s (p &lt; .01) extensor torque on the affected limb (AL), and eccentric at 30 and 120º/s (p &lt; .01), on the non-affected limb (NAL). In the flexors, there was an increase on the torque: isometric, concentric at 30º/s and eccentric at 30 and 120º/s (p &lt; .01) in AL and in eccentric at 30 (p &lt; .05) and 120º/s (p &lt; .01) in NAL. With respect to the angular and spatio-temporal variables gait, there was no difference between pre-and post-training in LCAr group. Compared to control group, the cycle time, in two members, was lower in LCAr group, and stride length and cadence were higher in the AL of the LCAr (p &lt; .05). Moreover, the knee flexion-extension angles (minimum and maximum) remained lower in LCAr, pre-and post-training (p &lt; .01). The torque gain associated with eccentric isokinetic training did not affect the kinematic parameters of gait in patients undergoing ACL reconstruction. Keywords: gait, exercise, muscle strength, movement, anterior cruciate ligament reconstruction Resumo-&quot;Efeitos do treinamento isocinético excêntrico de extensores de joelho e torque flexor na marcha de indivíduos com reconstrução do LCA: Um ensaio clínico controlado.&quot; Este estudo investigou os efeitos do treinamento isocinético excêntrico (TIE) sobre o torque extensor e flexor do joelho e parâmetros cinemáticos da marcha de indivíduos com reconstrução do LCA. Dezesseis homens com LCA reconstruído (LCAr), foram avaliados quanto ao torque e marcha, antes e após 12 semanas de TIE e comparados com um grupo controle (14 indivíduos). Testes t Student, MANOVA e ANOVA foram realizados com 5% de significância. O treinamento aumentou o torque extensor isométrico, concêntrico a 30 e 120º/s (p &lt; 0,05) e excêntrico a 30º/s (p &lt; 0,01) no membro afetado (MA), e excêntrico a 30 e 120º/s (p &lt; 0,01), no membro não afetado (MNA). Nos flexores, houve um aumento no torque: isométrico, concêntrico a 30º/s e excêntrico a 30 e 120º/s (p &lt; 0,01) no MA, e excêntrico a 30 (p &lt; 0,05) e 120º/s (p &lt; 0,01) no MNA. Com relação às variáveis espaço-temporais e angulares da marcha, não houve diferença entre as avaliações pré e pós-treino no grupo LCAr. Comparado ao controle, a duração do ciclo, nos dois membros, foi menor no LCAr, e comprimento da passada e cadência foram maiores no MA do grupo LCAr (p &lt; 0,05). Além disso, os ângulos (mínimo e máximo) de flexão-extensão do joelho permaneceram menores no LCAr, pré e pós-treino (p &lt; 0,01). O ganho de torque associado ao treinamento isocinético excêntrico não modificou os parâmetros cinemáticos da marcha nos indivíduos submetidos à reconstrução do LCA. Palavras-chave: marcha, exercício, força muscular, movimento, reconstrução do ligamento cruzado anterior H.H. Santos, C.O. Sousa, J.A. Barela, A.M.F. Barela &amp; T.F. Salvini Motriz, Rio Claro, v.20 n.4, p. 431-441, Oct./Dec. 2014 432 Resumen-&quot;Efectos del entrenamiento excéntrico isocinético en extensor de la rodilla y el par flexor y sobre la marcha de las personas con reconstrucción ACL: Un ensayo clínico controlado.&quot; Este estudio investigó los efectos del entrenamiento isocinético excéntrico (EIE) en el torque del extensor y del flexor de la rodilla y parámetros cinemáticos de la marcha de personas con la reconstrucción del LCA. Dieciséis hombres con LCA reconstruido (LCAr), fueron evaluados para el par y la marcha antes y después de 12 semanas de EIE y se compararon con un grupo control (14 personas). Prueba t Student, ANOVA y MANOVA se realizaron con 5 % de significación. La formación aumentó extensor torque isométrico, concéntrico 30 y 120°/s (p &lt; 0,05) y la excéntrica 30°/s (p &lt; 0,01) en el miembro afectado (MA), y la excéntrica 30 y 120°/s (p &lt; 0,01) en el miembro no afectado (MNA). Flexor, hubo un aumento en el par motor: isométrica , concéntrica 30°/s excéntrica 30 y 120°/s (p &lt; 0,01) en MA, excéntrico y 30 (p &lt; 0,05 ) y 120°/ s (p &lt; 0,01) en el MNA. Con respecto a las variables angulares y espacio-temporal de andar, no hubo diferencia entre pre y post-entrenamiento en grupo LCAr. En comparación con el grupo control, el tiempo de ciclo, em los dos miembros, fue menor en LCAr, y la longitud del paso y cadencia fueron mayores en el LCAr del MA (p &lt; 0,05). Por otra parte, los ángulos de flexión-extensión de la rodilla (mínimo y máximo) se mantuvieron bajos en LCAr, pre y post-entrenamiento (p &lt; 0,01). El aumento del torque asociado con el entrenamiento isocinético excéntrico no afectó los parámetros cinemáticos de la marcha en las personas sometidas a la reconstrucción del LCA

Optical Flow Structure Effects in Children's Postural Control.

The aim of this study was to investigate the effect of distance and optic flow structure on visual information and body sway coupling in children and young adults. Thirty children (from 4 to 12 years of age) and 10 young adults stood upright inside of a moving room oscillating at 0.2 Hz, at 0.25 and 1.5 m from the front wall, and under three optical flow conditions (global, central, and peripheral). Effect of distance and optic flow structure on the coupling of visual information and body sway is age-dependent, with 4-year-olds being more affected at 0.25 m distance than older children and adults are. No such difference was observed at 1.5 m from the front wall. Moreover, 4-year-olds' sway was larger and displayed higher variability. These results suggest that despite being able to accommodate change resulting from varying optic flow conditions, young children have difficulty in dodging stronger visual stimuli. Lastly, difference in sway performance may be due to immature inter-modality sensory reweighting

Diferenças sensoriais e motoras entre jovens e idosos: contribuição somatossensorial no controle postural

OBJETIVOS: Comparar o desempenho dos sistemas sensoriais e motor entre jovens e idosos e identificar as contribuições das possíveis diferenças para o controle postural. MÉTODOS: Vinte idosos (68,9±3,7 anos de idade) e 20 jovens (21,9±2,1anos de idade) realizaram testes visuais; somatossensoriais (sensibilidade cutânea e cinestésica); motores (torque articular e latência de ativação muscular) e de controle postural (postura ereta em semi-tandem). RESULTADOS: As análises de variância (ANOVAs) e as análises de multivariância (MANOVAs) indicaram desempenho inferior dos idosos nos testes sensoriais: acuidade visual (p=0,001); sensibilidade ao contraste visual (p=0,009); sensibilidade cutânea (p<0,001); sensibilidade cinestésica de joelho (p<0,001) e tornozelo (<0,001), e motores: torque em flexão de joelho feminino (p=0,010) e masculino (p<0,001); extensão de joelho feminino (p=0,002) e masculino (p<0,001); dorsiflexão de tornozelo feminino (p=0,029) e masculino (p=0,006), flexão plantar de tornozelo feminino (p=0,004) e masculino (p=0,004) e latência de ativação muscular (p<0,001). Os idosos também apresentaram maior oscilação corporal na direção ântero-posterior (p=0,035). Análise de regressão múltipla revelou que a percepção ao movimento passivo foi a única variável que contribuiu para a maior oscilação corporal na direção ântero-posterior em idosos, R²=0,142, p<0,05. CONCLUSÕES: Diferenças no desempenho sensorial e motor ocorrem entre jovens e idosos e atenção deveria ser direcionada para a contribuição do sistema proprioceptivo para o controle postural de idosos.OBJECTIVES: The aim of this study was to compare the performance of the sensory and motor systems and the contributions of possible differences to postural control. METHODS: Twenty older adults (68.9±3.7 years of age) and twenty young adults (21.9±2.1 years of age) underwent visual, somatosensory (tactile and kinesthetic sensitivity), motor tests (joint torque and muscle activation latency) and postural control assessments (upright semi-tandem posture). RESULTS: MANOVA and ANOVA indicated that older adults had a poorer performance in the sensory tests: visual acuity (p=0.001), visual contrast sensitivity (p=0.009), tactile sensitivity (p<0.001) and kinesthetic sensitivity of the knee (p<0.001) and ankle (<0.001); and in the motor tests: female (p=0.010) and male (p<0.001) knee flexion torque; female (p=0.002) and male (p<0.001) knee extension torque; female (p=0.029) and male (p=0.006) ankle dorsiflexion torque; female (p=0.004) and male (p=0.004) ankle plantar flexion torque; and muscle activation latency (p<0.001). The older adults also had greater body sway amplitude on the anterior-posterior direction (p=0.035). Multiple regression analysis revealed that perception of passive motion was the only variable that contributed to greater body sway on the anterior-posterior direction among older adults (R²=0.142; p<0.05). CONCLUSIONS: There are differences in sensory and motor performance between young adults and older adults, and attention should be directed toward the contribution of the proprioceptive system to postural control among older adults.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Perception-action coupling in infants with down syndrome: Effects of experience and practice

This study examined the effects of experience and practice on the coupling between visual information and trunk sway in infants with Down syndrome (DS). Five experienced and five novice sitters were exposed to a moving room, which was oscillated at 0.2 and 0.5 Hz. Infants remained in a sitting position and data were collected on the first, fourth, and seventh days. On the first day, experienced sitters were more influenced by room oscillation than were novices. On the following days, however, the influence of room oscillation decreased for experienced but increased for novice sitters. These results suggest that the relationship between sensory information and motor action in infants with DS can be changed with experience and practice

Influence of Imposed Optic Flow Characteristics and Intention on Postural Responses

Determinar la incidencia del régimen de Restitución de Derechos Arancelarios, en el incentivo de las exportaciones por las empresas productoras-exportadoras en el Perú, periodos 2012-2014. Material y métodos: Investigación inductiva – deductiva, se sustenta en estudios de observación, aplicación de encuestas, análisis documental y entrevistas. Utiliza: cuestionarios, revisión documental, diseño y validación cotejada en el marco teórico. La población está constituido por las empresas productoras-exportadoras del régimen de Restitución de Derechos Arancelarios, en un total de 100 beneficiarios principales. El nivel de investigación es Descriptivo. Resultados: Las exportaciones de Perfeccionamiento Activo, nos muestra que el régimen de Restitución de Derechos Arancelarios ocupa el primer lugar con 85%, frente a un 8% de Reposición de Mercancías en Franquicia y un poco postergado con un 7% del régimen de Admisión Temporal. Conclusiones: El Régimen de Restitución de Derechos Arancelarios, tiene un fuerte grado de influencia en el incentivo de las exportaciones por las empresas productoras-exportadoras; las exportaciones de Perfeccionamiento Activo, nos muestra notoriamente que el Régimen de Restitución de Derechos Arancelarios ocupa el primer lugar con 79%, frente a un 11% de Reposición de Mercancías en Franquicia y un poco postergado con un 10% del régimen de Admisión Temporal.Tesi

Position and velocity variability.

<p>Mean position (A-C) and velocity (D-F) variability values for all age groups in the anterior-posterior direction at two distances under global (A, D), peripheral (B, E), and central optic flow (C, F) experimental conditions.</p