of an article published in Archives of Physical Medicine and
Rehabilitation say their study is the first step toward discerning
the underlying factors contributing to improved walking performance in
individuals with chronic stroke.
study, 27 patients with hemiparetic stroke (17 left hemiparesis, 19 men, age:
58.7 + 13.0 years, 22.7 + 16.4 months poststroke) were stratified based on a
walking speed change of greater than (responders) or less than (nonresponders)
0.16 m/s. Paired sample t-tests were run to assess changes in each group, and
correlations were run between the change in each variable and change in walking
patients participated in a 12-week locomotor intervention incorporating
training on a treadmill with body weight support and manual trainers
accompanied by training overground walking. Motor control, balance, functional
walking ability, and endurance were collected at pre- and postintervention
responders and 9 nonresponders differed by age (responders=63.6 years,
nonresponders=49.0 years) and the lower extremity Fugl-Meyer (responders=24.7, nonresponders=19.9).
Responders demonstrated an average improvement in walking speed of 0.27 m/s as
well as significant gains in all variables except daily step activity and paretic step ratio. Conversely, the nonresponders
demonstrated statistically significant improvements only in walking speed and
endurance. However, the walking speed increase of 0.10 m/s was not clinically
meaningful. Change in walking speed was negatively correlated with changes in motor
control in the nonresponder group, implying that walking speed gains may have
been accomplished via compensatory mechanisms.
member Mark G. Bowden, PT, PhD, is the article's lead author. APTA
members Andrea L. Behrman, PT, PhD,
FAPTA, and Chris M. Gregory, PT, PhD,
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