Hemiparesis;Poststroke/CVA
Conditions
Brief summary
Individuals with stroke have balance and gait deficits. Gait training does improve balance and gait abilities, but adding perturbations may have increase these effects. The objective was to compare the effect gait training with and without perturbations on balance and gait abilities in individuals with hemiparesis due to stroke at a chronic stage.
Interventions
DEVICEGait training with perturbations
Changes in speed of one of the belt of the split belt treadmill during swing phase
DEVICEGait training without perturbation
Walking on a treadmill with steady belt speed
Sponsors
Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome measures pretraining were collected pre-randomization. Post-training, the assessors were masked for the arm.
Intervention model description
Only the experimental intervention was offered in the second phase of the trial, to the participants who received the control intervention in the first phase
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* able to walk at a comfortable speed less than 1.0 m/s * have reduced dynamic balance capacities (as evaluated by the mini-BESTest; score below the 95% confidence interval of the mean score of the corresponding age group of normative data) * with or without a history of fall * be able to walk on a treadmill, without external support, such as handrails or walking aid, for at least 1 minute
Exclusion criteria
* hemineglect (more than 6 omissions on the bell cancellation test), * cognitive impairment (Mini-Mental State Examination score under 24/30) * uncorrected visual deficit or pathologies other than stroke which can affect their gait or balance
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Balance capacities | Within the week pre-training | Score at the mini-Balance Evaluation System Test (mini-BESTest). Score between 0 and 28. Higher scores associated with better balance abilities. |
| Gait capacities | Within the week pre-training | Self-selected and fast gait speed measured over 10 meters (10 meter walking test) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Paretic and non-paretic maximal knee extensor strength | Within the week pre-training | Measure of isometric, maximal knee extensor strength at each knee, using an instrumented dynamometer (Biodex). |
| Balance confidence | Within the week pre-training | Score at the Activity-specific Balance Confidence (ABC scale), between 0 and 100%, with 100% indicating better balance confidence |
| Community reintegration | Within the week pre-training | Score at the Reintegration to Normal Living Index (RNLI), between 0 and 22, with 0 indicating total reintegration. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Laboratory gait analysis : kinetics | Within the week pre-training | Ground reaction forces and centre of pressure during gait at natural and fast speed and during gait perturbations |
| Laboratory gait analysis : kinematics | Within the week pre-training | Lower-limb joint angles, centre of mass during gait at natural and fast speed and during gait perturbations |
| Laboratory gait analysis : electromyographic activity | Within the week pre-training | EMG activity of 5 muscle groups (tibialis anterior, soleus, rectus femoris, medial hamstring, paravertebral muscles at L3) bilateraly during gait at natural and fast speed and during gait perturbations |
| Satisfaction with gait perturbation intervention | Within the week post-training | Score at the Short Feedback Questionnaire. Rating from Not at all to Extremely to 9 questions. No total score. Answers interpreted for each question. |
Outcome results
None listed