title: Targeting paretic propulsion to improve poststroke walking function: a preliminary study.
abstract: OBJECTIVE
  To determine the feasibility and safety of implementing a 12-week locomotor intervention targeting paretic propulsion deficits during walking through the joining of 2 independent interventions, walking at maximal speed on a treadmill and functional electrical stimulation of the paretic ankle musculature (FastFES); to determine the effects of FastFES training on individual subjects; and to determine the influence of baseline impairment severity on treatment outcomes.
  
  
  METHODS
  Single group pre-post preliminary study investigating a novel locomotor intervention.
  
  
  METHODS
  Research laboratory.
  
  
  METHODS
  Individuals (N=13) with locomotor deficits after stroke.
  
  
  METHODS
  FastFES training was provided for 12 weeks at a frequency of 3 sessions per week and 30 minutes per session.
  
  
  METHODS
  Measures of gait mechanics, functional balance, short- and long-distance walking function, and self-perceived participation were collected at baseline, posttraining, and 3-month follow-up evaluations. Changes after treatment were assessed using pairwise comparisons and compared with known minimal clinically important differences or minimal detectable changes. Correlation analyses were run to determine the correlation between baseline clinical and biomechanical performance versus improvements in walking speed.
  
  
  RESULTS
  Twelve of the 13 subjects that were recruited completed the training. Improvements in paretic propulsion were accompanied by improvements in functional balance, walking function, and self-perceived participation (each P<.02)-all of which were maintained at 3-month follow-up. Eleven of the 12 subjects achieved meaningful functional improvements. Baseline impairment was predictive of absolute, but not relative, functional change after training.
  
  
  CONCLUSIONS
  This report demonstrates the safety and feasibility of the FastFES intervention and supports further study of this promising locomotor intervention for persons poststroke.
authors.affiliation: Biomechanics and Movement Science Program, University of Delaware, Newark, DE; Department of Physical Therapy, University of Delaware, Newark, DE. Electronic address: louawad@udel.edu.
authors.forename: Louis N
authors.initials: LN
authors.lastname: Awad
authors.affiliation: Biomechanics and Movement Science Program, University of Delaware, Newark, DE; Department of Physical Therapy, University of Delaware, Newark, DE.
authors.forename: Darcy S
authors.initials: DS
authors.lastname: Reisman
authors.affiliation: Division of Physical Therapy, Emory University, Atlanta, GA; Department of Rehabilitation Medicine, Emory University, Atlanta, GA.
authors.forename: Trisha M
authors.initials: TM
authors.lastname: Kesar
authors.affiliation: Biomechanics and Movement Science Program, University of Delaware, Newark, DE; Department of Physical Therapy, University of Delaware, Newark, DE.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Binder-Macleod
mesh_terms: D000368:Aged; D005080:Exercise Test; D005081:Exercise Therapy / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008124:Locomotion / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D020127:Recovery of Function; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*
keywords: Paresis; Rehabilitation; Stroke; Walking