title: Gait training after stroke: a pilot study combining a gravity-balanced orthosis, functional electrical stimulation, and visual feedback.
abstract: BACKGROUND
  This case report describes the application of a novel gait retraining approach to an individual with poststroke hemiparesis. The rehabilitation protocol combined a specially designed leg orthosis (the gravity-balanced orthosis), treadmill walking, and functional electrical stimulation to the ankle muscles with the application of motor learning principles.
  
  
  METHODS
  The participant was a 58-year-old man who had a stroke more than three years before the intervention. He underwent gait retraining over a period of five weeks for a total of 15 sessions during which the gravity compensation provided by the gravity-balanced orthosis and visual feedback about walking performance was gradually reduced.
  
  
  RESULTS
  At the end of five weeks, he decreased the time required to complete the Timed Up and Go test; his gait speed increased during overground walking; gait was more symmetrical; stride length, hip and knee joint excursions on the affected side increased. Except for gait symmetry, all other improvements were maintained one month post-intervention.
  
  
  CONCLUSIONS
  This case report describes possible advantages of judiciously combining different treatment techniques in improving the gait of chronic stroke survivors. Further studies are planned to evaluate the effectiveness of different components of this training in both the subacute and chronic stages of stroke recovery.
authors.affiliation: Physical Therapy Department, University of Delaware, Newark, Delaware, USA.
authors.forename: Vijaya
authors.initials: V
authors.lastname: Krishnamoorthy
authors.forename: Wei-Li
authors.initials: WL
authors.lastname: Hsu
authors.forename: Trisha M
authors.initials: TM
authors.lastname: Kesar
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Benoit
authors.forename: Sai K
authors.initials: SK
authors.lastname: Banala
authors.forename: Ramu
authors.initials: R
authors.lastname: Perumal
authors.forename: Vivek
authors.initials: V
authors.lastname: Sangwan
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Binder-Macleod
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Agrawal
authors.forename: John P
authors.initials: JP
authors.lastname: Scholz
mesh_terms: D004599:Electric Stimulation Therapy; D004867:Equipment Design; D030141:Feedback, Psychological; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006112:Gravitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D010865:Pilot Projects; D011597:Psychomotor Performance / Q000502:physiology*; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation