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  • New in the Literature: Locomotor Rehabilitation of Individuals With Chronic Stroke (Arch Phys Med Rehabil. 2012, Dec 4. [Epub ahead of print])

    Authors 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.

    For this 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 speed.

    The 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 assessments.

    Eighteen 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.

    APTA 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, are coauthors.

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