NeuroRehabilitation - Volume 16, issue 3

Authors: Seif-Naraghi, Amir

Article Type: Editorial

DOI: 10.3233/NRE-2001-16301

Citation: NeuroRehabilitation, vol. 16, no. 3, pp. 131-132, 2001

Authors: Hesse, Stefan

Article Type: Research Article

Abstract: Gait rehabilitation is a major aspect of neurological rehabilitation. This review is on locomotor therapy by treadmill stimulation with partial body weight support evolving as a very promising treatment concept over the last years. It enables severely affected patients the repetitive practice of complex gait cycles and thus follows modern aspects of motor learning favoring a task-specific approach. Several studies have shown its potential in patients after stroke, spinal cord injury, M. Parkinson and cerebral palsy. An electromechanical gait trainer relieving the strenuous effort of the therapists and controlling the trunk in a phase-dependent manner is a new alternative.

Keywords: locomotor therapy, treadmill training, body weight support, gait trainer, neurological rehabilitation

DOI: 10.3233/NRE-2001-16302

Citation: NeuroRehabilitation, vol. 16, no. 3, pp. 133-139, 2001

Authors: Trueblood, Peggy R.

Article Type: Research Article

Abstract: Purpose: A series of pilot studies were conducted to examine the effects of partial body weight (PBW) ambulation in people with chronic stroke. Methods: First, we compared gait characteristics during 3 modes of walking: level ground ambulation; level ground ambulation with PBW; and treadmill ambulation with PBW. Second, we examined the effects of repeated PBW treadmill training during level ground ambulation. Results: Improved symmetry in stance/swing times and sEMG activity of pre-tibialis and quadriceps muscle groups during PBW either over level ground or on the treadmill occurred in 10 chronic stroke subjects. Increased single limb support …and decreased double limb support improved overall gait symmetry during level ground ambulation in 8 subjects following 6–8 weeks repeated PBW treadmill training. Tinetti Balance score also significantly improved. No changes in sEMG were observed. Conclusion: These results suggest that PBW treadmill may help normalize gait and improve balance in the person with chronic stroke. Show more

Keywords: stroke, partial body weight, gait, rehabilitation, electromyography (EMG)

DOI: 10.3233/NRE-2001-16303

Citation: NeuroRehabilitation, vol. 16, no. 3, pp. 141-153, 2001

Authors: Miller, Ellen Winchell

Article Type: Research Article

Abstract: This study was designed to consider the feasibility and effectiveness of combined body weight support (BWS) treadmill and overground training for a 71-year-old woman 19 months post left embolic middle cerebral artery stroke. The study used a modified single subject withdrawal design (ABAA). Initial baseline performance (A1) was established using a set of functional assessment tools for balance, mobility and gait. Intervention (B) was introduced and removed, and a second baseline performance (A2) was recorded. After a one-month delay, final baseline performance was established. During intervention, the participant was involved in combined BWS training three times/week for eight weeks. Single …subject analyses and pre/posttest analyses were conducted. Results revealed that 17 of 20 indicators (85%) nine indicators (89%) performance one-month post intervention. Combined BWS training was feasible and effective in improving and maintaining functional performance in this participant. Show more

Keywords: body weight support, stroke, partial weight bearing, treadmill, overground, ambulation

DOI: 10.3233/NRE-2001-16304

Citation: NeuroRehabilitation, vol. 16, no. 3, pp. 155-163, 2001

Authors: Sadowsky, Cristina L.

Article Type: Research Article

Abstract: The use of electricity to stimulate nerves or muscles is nothing new. In the 18th century Galvani recognized that electricity could be converted into "nerve force". Numerous applications of electrical stimulation have been explored, most notably cardiac pacing, cochlear implants or transcutaneous electrical nerve stimulation (TENS) units for pain control. Spinal cord injury (SCI), with its “transecting lesion” that leaves intact nervous system below the injury completely disconnected from the centers that exert motor control provides the ideal opportunity for electrical stimulation use. Multiple applications are being investigated, including those for aerobic conditioning/cardiovascular exercise, cough and breathing assistance, …improving bowel and bladder control, erection and ejaculation, hand grasp, spasticity management, neuro-muscular reeducation, standing and walking, etc. This review will focus on innovative and technologically advanced applications of electrical stimulation in the management of patients with spinal cord injury. Show more

DOI: 10.3233/NRE-2001-16305

Citation: NeuroRehabilitation, vol. 16, no. 3, pp. 165-169, 2001

Authors: Maulucci, Ruth A. | Eckhouse, Richard H.

Article Type: Research Article

Abstract: Stroke is the third leading cause of death in the United States. The aim of the present study was to enhance the motor recovery of patients in the chronic stroke period by means of upper extremity trajectory modification through real-time auditory feedback. A system of hardware, software, and feedback algorithms was developed. Two groups of patients in the chronic stroke period were trained on the system, one with practice and feedback and one with practice alone. Twenty reach parameters were defined and analyzed for differences between the first and last training sessions, between adaptation and learning trials, and among three …targets. This study demonstrated that modification of the reach trajectory can be accomplished during the chronic stroke period either with practice alone or through practice accompanied by auditory feedback. However, improved path performance requires auditory feedback training, and cannot be achieved by practice alone. Show more

Keywords: stroke, reaching, arm trajectories, end effector path, real-time feedback, treatment

DOI: 10.3233/NRE-2001-16306

Citation: NeuroRehabilitation, vol. 16, no. 3, pp. 171-182, 2001

Authors: Selby-Silverstein, Lisa | Hillstrom, Howard J. | Palisano, Robert J.

Article Type: Research Article

Abstract: The purpose of this study was to determine if foot orthoses (FOs) immediately affected gait of children with Down Syndrome (DS) and excessively pronated feet. Subjects were 3–6 years old; 16 with DS and 10 without disabilities. Gait of children with DS wearing sneakers was compared with and without FOs and compared to gait of children without disabilities. Ankle moment, walking speed during stance phase, sneaker prints, center of pressure, and transverse plane foot angles were collected and compared. In standing, heel eversion was reduced when the children wore FOs (p = 0.000 ). During gait the …transverse plane foot angle decreased indicating more internal rotation with FOs (p = 0.000 ). Trial-to-trial variability of pronation-supination index (p = 0.0001 ), foot length contact (p = 0.0001 ), transverse plane foot angle (p = 0.0003 ), and walking speed (p = 0.0001 ) all decreased with FO use. Trial-to-trial variability of normalized peak ankle moment (p = 0.0001 ), and of phase of peak ankle moment (p = 0.0001 ) increased when the children wore FOs. Show more

Keywords: down syndrome, foot orthoses, gait, ankle moment, plantar pressure, foot motion

DOI: 10.3233/NRE-2001-16307

Citation: NeuroRehabilitation, vol. 16, no. 3, pp. 183-193, 2001