Influence of systematic increases in treadmill walking speed on gait kinematics after stroke.
BACKGROUND
Fast treadmill training improves walking speed to a greater extent than training at a self-selected speed after stroke. It is unclear whether fast treadmill walking facilitates a more normal gait pattern after stroke, as has been suggested for treadmill training at self-selected speeds. Given the massed stepping practice that occurs during treadmill training, it is important for therapists to understand how the treadmill speed selected influences the gait pattern that is practiced on the treadmill.


OBJECTIVE
The purpose of this study was to characterize the effect of systematic increases in treadmill speed on common gait deviations observed after stroke.


METHODS
A repeated-measures design was used.


METHODS
Twenty patients with stroke walked on a treadmill at their self-selected walking speed, their fastest speed, and 2 speeds in between. Using a motion capture system, spatiotemporal gait parameters and kinematic gait compensations were measured.


RESULTS
Significant improvements in paretic- and nonparetic-limb step length and in single- and double-limb support were found. Asymmetry of these measures improved only for step length. Significant improvements in paretic hip extension, trailing limb position, and knee flexion during swing also were found as speed increased. No increases in circumduction or hip hiking were found with increasing speed. Limitations Caution should be used when generalizing these results to survivors of a stroke with a self-selected walking speed of less than 0.4 m/s. This study did not address changes with speed during overground walking.


CONCLUSIONS
Faster treadmill walking facilitates a more normal walking pattern after stroke, without concomitant increases in common gait compensations, such as circumduction. The improvements in gait deviations were observed with small increases in walking speed.
Department of Physical Therapy, University of Delaware, Newark, Delaware, DE 19716 , USA.
Christine M
CM
Tyrell
Margaret A
MA
Roos
Katherine S
KS
Rudolph
Darcy S
DS
Reisman
D000368:Aged; D001696:Biomechanical Phenomena / Q000502:physiology; D005081:Exercise Therapy / Q000295:instrumentation; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*
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