Effect of bilateral step-up and -down training on motor function in a person with hemiparesis: a case report.
Gait training to facilitate the use of the paretic limb for persons with hemiparesis continues to be of interest to those in the clinical research domain. The purpose of this case report was to assess the outcomes of a repeated step-up and -down treatment, initiating with the paretic limb, on functional mobility, endurance and gait kinematic parameters in a person with hemiparesis. The participant was an 85-year-old female 3 years status post left hemiparesis, who reported overall good health. The participant was asked to step up on a 1-inch height wood box with her paretic limb. Once both feet were on top of the box, the participant initiated descent also with her paretic limb. The height of the box gradually progressed to 5 inches based on the participant's performance and tolerance. A metronome was used to facilitate rhythmic lower extremity movement patterns. The training duration for each treatment session was 7-15 min/day. The participant completed nine sessions spanning over 3 weeks. The outcome measure used to identify motor recovery was the Fugl-Myer (lower extremity). In addition, the timed up and go (TUG), the 6-min walk test (6 MWT) and gait kinematics were assessed to examine mobility and gait. The Fugl-Myer score and 6 MWT did not reflect a meaningful change (0% and +2.6%, respectively). However, TUG scores did show a meaningful change (+31.9%). With respect to gait kinematics, hip flexion on the paretic limb was improved from 11° to 18°, which indicates the normal range of hip motion during the initial swing phase in post-test.
Physical Therapy Program, Angelo State University , San Angelo, TX , USA .
Mansoo
M
Ko
Sean
S
Hilgenberg
Scott M
SM
Hasson
Heather J
HJ
Braden
D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D004185:Disability Evaluation; D005080:Exercise Test; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D009043:Motor Activity; D010291:Paresis / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome
Functional mobility; gait training; hemiparesis