Gait characteristics after gait-oriented rehabilitation in chronic stroke.
OBJECTIVE
To assess the effects of rehabilitation in thirty-seven ambulatory patients with chronic stroke during three weeks in-patient rehabilitation period.


METHODS
In the intervention group, each patient received 75 min physiotherapy daily every workday including 20 minutes in the electromechanical gait trainer with body-weight support (BWS). In the control group, each patient participated in 45 min conventional physiotherapy daily. Motor ability was assessed with the first five items of the Modified Motor Assessment Scale (MMAS1-5) and ten meters walking speed. Spatio-temporal gait characteristics were recorded with an electrical walkway.


RESULTS
The MMAS1-5 (p<0.0005 and p=0.005) and ten meters walking time (p<0.0005 and p=0.006) improved in both groups. The improvements in MMAS1-5 and ten meters walking time did not differ between the groups (p=0.217 and p=0.195). Specific gait characteristics improved only in the intervention group, as seen in increased Functional Ambulation Profile score (p=0.023), velocity (p=0.023), the step lengths (affected side, p=0.011, non-affected side p=0.040), the stride lengths (p=0.018, p=0.006) and decreased step-time differential (p=0.043). Furthermore, all gait characteristics and other motor abilities remained in the discharge level at the six months in the intervention group.


CONCLUSIONS
It appears that BWS training gives a long-lasting benefit in gait qualities even in chronic stroke patients.
Brain Research and Rehabilitation Center Neuron, Kuopio, Finland. sinikka.peurala@neuron.fi
Sinikka H
SH
Peurala
Ekaterina B
EB
Titianova
Plamen
P
Mateev
Kauko
K
Pitkänen
Juhani
J
Sivenius
Ina M
IM
Tarkka
D000328:Adult; D000553:Ambulatory Care / Q000379:methods; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002908:Chronic Disease; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016138:Walking / Q000502:physiology*