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Title: Training conditions influence walking kinematics and self selected walking speed in patients with neurological impairments.
Epworth Authors: Williams, Gavin
Morris, Meg
Other Authors: Schache, Anthony
Clark, Ross
Moore, Liz
Fini, Natalie
McCrory, Paul
Keywords: Biomechanical Phenomena
Locomotor Function
Recovery of Function
Brain Injuries
Injuries, Brain
Trauma, Brain
Traumatic Brain Injury
Assistive Technology
Orthotic Devices
Training Techniques
Physiotherapy Department, Epworth Hospital, Melbourne, Victoria, Australia
Issue Date: Feb-2011
Publisher: Mary Ann Liebert, Inc.
Citation: Journal of Neurotrauma 2011 February; 28:281–287
Abstract: Gait training is a major focus of rehabilitation for many people with neurological disorders, yet systematic reviews have failed to identify the most effective form of gait training. The main objective of this study was to compare conditions for gait training for people with acquired brain injury (ABI). Seventeen people who had sustained an ABI and were unable to walk without assistance were recruited as a sample. Each participant was exposed to seven alternative gait training conditions in a randomized order. These were: (1) therapist manual facilitation; (2) the use of a gait-assistive device; (3) unsupported treadmill walking; and (4) four variations of body weight support treadmill training (BWSTT). Quantitative gait analysis was performed and Gait Profile Scores (GPS) were generated for each participant to determine which condition most closely resembled normal walking. BWSTT without additional therapist or self-support of the upper limbs was associated with more severe gait abnormality [Wilks’ lambda¼0.20, F(6, 6)¼3.99, p¼0.047]. With the exception of therapist facilitation, the gait training conditions that achieved the closest approximation of normal walking required selfsupport of the upper limbs. When participants held on to a stable handrail, self-selected gait speeds were up to three times higher than the speeds obtained for over-ground walking [Wilks’ lambda¼0.17, F(6, 7)¼5.85, p<0.05]. The provision of stable upper-limb support was associated with high self-selected gait speeds that were not sustained when walking over ground. BWSTT protocols may need to prioritize reduction in self-support of the upper limbs, instead of increasing treadmill speed and reducing body weight support, in order to improve training outcomes.
DOI: 10.1089/neu.2010.1649
PubMed URL:
ISSN: 0897-7151
Journal Title: Journal of Neurotrauma
Type: Journal Article
Affiliated Organisations: Centre for Health Exercise and Sports Medicine, The University of Melbourne, Melbourne, Victoria, Australia
School of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.
School of Mechanical Engineering, The University of Melbourne, Melbourne, Victoria, Australia
Caulfield Hospital, Alfred Healthcare, Melbourne, Victoria, Australia
Type of Clinical Study or Trial: Randomized Controlled Clinical Trial/Controlled Clinical Trial
Appears in Collections:Neurosciences

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