title: Bilateral coordination and gait symmetry after body-weight supported treadmill training for persons with chronic stroke.
abstract: BACKGROUND
  Locomotor interventions are commonly assessed using functional outcomes, but these outcomes provide limited information about changes toward recovery or compensatory mechanisms. The study purposes were to examine changes in gait symmetry and bilateral coordination following body-weight supported treadmill training in individuals with chronic hemiparesis due to stroke and to compare findings to participants without disability.
  
  
  METHODS
  Nineteen participants with stroke (>6 months) who ambulated between 0.4 and 0.8 m/s and 22 participants without disability were enrolled in this repeated-measures study. The stroke group completed 24 intervention sessions over 8 weeks with 20 minutes of walking/session. The non-disabled group served as a comparison for describing changes in symmetry and coordination. Bilateral 3-dimensional motion analysis and gait speed were assessed across 3 time points (pre-test, immediate post-test, and 6-month retention). Continuous relative phase was used to evaluate bilateral coordination (thigh-thigh, shank-shank, foot-foot) and gait symmetry was assessed with spatiotemporal ratios (step length, swing time, stance time).
  
  
  RESULTS
  Significant improvements in continuous relative phase (shank-shank and foot-foot couplings) were found at post-test and retention for the stroke group. Significant differences in spatiotemporal symmetry ratios were not found over time. Compared to the non-disabled group, changes in bilateral coordination moved in the direction of normal recovery. Most measures of continuous relative phase were more responsive to change after training than the spatiotemporal ratios.
  
  
  CONCLUSIONS
  After body-weight supported treadmill training, the stroke group made improvements toward recovery of normal bilateral coordination. Bilateral coordination and gait symmetry measures may assess different aspects of gait.
authors: Krannert School of Physical Therapy, University of Indianapolis, 1400 East Hanna Avenue, Indianapolis, IN 46227, USA. scombs@uindy.edu
authors: Stephanie A
authors: SA
authors: Combs
authors: Eric L
authors: EL
authors: Dugan
authors: Elicia N
authors: EN
authors: Ozimek
authors: Amy B
authors: AB
authors: Curtis
mesh_terms: D000328:Adult; D000368:Aged; D001259:Ataxia / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D001835:Body Weight; D002908:Chronic Disease; D005080:Exercise Test; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D000071939:Stroke Rehabilitation