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dc.contributor.authorWilliams, Gavin-
dc.contributor.otherClark, Ross-
dc.contributor.otherFini, Natalie-
dc.contributor.otherMoore, Liz-
dc.contributor.otherBryant, Adam-
dc.identifier.citationArchives of Physical Medicine and Rehabilitation 2012, 93 (4), 636-640.en_US
dc.description.abstractObjective: 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.en_US
dc.subjectPhysiotherapy Department, Epworth Healthcare, Melbourne, Australiaen_US
dc.subjectPostural Balanceen_US
dc.subjectBalance, Posturalen_US
dc.subjectMotor Activityen_US
dc.subjectPhysical Exertionen_US
dc.subjectBrain Injuriesen_US
dc.subjectInjuries, Brainen_US
dc.subjectTrauma, Brainen_US
dc.subjectTraumatic Brain Injuryen_US
dc.subjectRecovery of Functionen_US
dc.subjectNeurologic Deficitsen_US
dc.subjectTraining Programsen_US
dc.subjectEducation of Patientsen_US
dc.subjectMotor Skills Disordersen_US
dc.subjectCoordination Impairmenten_US
dc.subjectWeight Supporten_US
dc.titleCoordination of dynamic balance during gait training in people with acquired brain injury.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleArchives of Physical Medicine and Rehabilitationen_US
dc.description.affiliatesDepartment of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australiaen_US
dc.description.affiliatesCaulfield Hospital, Alfred Health, Melbourne, VIC, Australiaen_US
dc.type.studyortrialRandomized Controlled Clinical Trial/Controlled Clinical Trialen_US
Appears in Collections:Neurosciences

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