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Title: Coordination of dynamic balance during gait training in people with acquired brain injury.
Authors: Williams, Gavin
Other Authors: Clark, Ross
Fini, Natalie
Moore, Liz
Bryant, Adam
Keywords: Physiotherapy Department, Epworth Healthcare, Melbourne, Australia
Postural Balance
Balance, Postural
Motor Activity
Physical Exertion
Brain Injuries
Injuries, Brain
Trauma, Brain
Traumatic Brain Injury
Recovery of Function
Neurologic Deficits
Training Programs
Education of Patients
Motor Skills Disorders
Coordination Impairment
Weight Support
Issue Date: Apr-2012
Publisher: Elsevier
Citation: Archives of Physical Medicine and Rehabilitation 2012, 93 (4), 636-640.
Abstract: Objective: To investigate movement of the center of mass (COM) during different gait training methods in people with neurologic conditions. Design: Coordination of the gait cycle, represented by mediolateral COM displacement amplitude, timing, and stability, was assessed during a variety of gait training methods performed in a single session. Setting: Gait laboratory. Participants: People who were unable to walk unassisted due to an acquired brain injury (n=17) and healthy control subjects (n=25). Interventions: The participants performed 7 alternative gait training methods in a randomized order. These were therapist manual facilitation, the use of a gait assistive device, treadmill walking with handrail support, and 4 variations of body weight–support treadmill training with combinations of handrail and/or therapist support. Main Outcome Measures: Mediolateral COM movement was analyzed in terms of displacement amplitude (overall range of motion), timing (relative to stride time), and stability (steadiness of the movement). Normative values for these measures were acquired from 25 healthy participants walking at a self-selected comfortable pace. Results: Body weight–support treadmill training without any additional support resulted in significantly (P<.05) greater amplitude, altered timing, and reduced movement stability compared with nonpathologic gait. Allowing handrail support or therapist facilitation reduced this effect and resulted in treadmill training (± body weight support) having lower movement amplitudes when compared with the other training methods. Therapist manual facilitation most closely matched nonpathologic gait for timing and stability. Conclusions: In the context of overall dynamic gait coordination, no single method of training provides the optimal stimulus. A training program that uses a variety of techniques may provide a beneficial rehabilitation response.
PubMed URL:
ISSN: 0003-9993
Journal Title: Archives of Physical Medicine and Rehabilitation
Type: Journal Article
Affiliated Organisations: Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia
Caulfield Hospital, Alfred Health, Melbourne, VIC, Australia
Type of Clinical Study or Trial: Randomized Controlled Clinical Trial/Controlled Clinical Trial
Appears in Collections:Neurosciences

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