Gait training after stroke: A pilot study combining a gravity-balanced orthosis, functional lectrical stimulation, and visual feedback

Journal of Neurologic Physical Therapy

Volumn 32, Issue 4, 2008, Pages 192-202

  Krishnamoorthy, Vijaya ^a,c   Hsu, Wei Li ^a,b,e   Kesar, Trisha M ^a,b   Benoit, Daniel L ^b,d   Banala, Sai K ^b   Perumal, Ramu ^a   Sangwan, Vivek ^b   Binder Macleod, Stuart A ^a,b   Agrawal, Sunil K ^b   Scholz, John P ^a,b  

^a Physical Therapy Department   (United States)

^b UNIVERSITY OF DELAWARE   (United States)

^c EMORY UNIVERSITY SCHOOL OF MEDICINE   (United States)

^d UNIVERSITY OF OTTAWA   (Canada)

^e UNIVERSITY OF OREGON   (United States)

Author keywords

Gait; Physical therapy; Recovery of function; Rehabilitation; Robotic training; Stroke; Walking

Indexed keywords

ADAPTIVE BEHAVIOR; ARTICLE; CASE REPORT; ELECTROSTIMULATION THERAPY; EQUIPMENT DESIGN; GRAVITY; HUMAN; MALE; MIDDLE AGED; NEUROLOGIC DISEASE; ORTHOTICS; PATHOPHYSIOLOGY; PHYSIOLOGY; PILOT STUDY; PSYCHOMOTOR PERFORMANCE; STROKE;

ELECTRIC STIMULATION THERAPY; EQUIPMENT DESIGN; FEEDBACK, PSYCHOLOGICAL; GAIT DISORDERS, NEUROLOGIC; GRAVITATION; HUMANS; MALE; MIDDLE AGED; ORTHOTIC DEVICES; PILOT PROJECTS; PSYCHOMOTOR PERFORMANCE; STROKE;

EID: 63249084606     PISSN: 15570576     EISSN: 15570584     Source Type: Journal    
DOI: 10.1097/NPT.0b013e31818e8fc2     Document Type: Article

References (63)

1. Rosamond W, Flegal K, Friday G, et al. Heart disease and stroke statistics - 2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115:e69-e171.
2. Mayo NE, Wood-Dauphinee S, Ahmed S, et al. Disablement following stroke. Disabil Rehabil. 1999;21:258-268.
3. Brandstater ME, de Bruin H, Gowland C, et al. Hemiplegic gait: analysis of temporal variables. Arch Phys Med Rehabil. 1983;64:583-587.
4. Olney SJ, Richards C. Hemiparetic gait following stroke, part I: characteristics. Gait Posture. 1996;4:136-148.
5. Perry J, Garrett M, Gronley JK, et al. Classification of walking handicap in the stroke population. Stroke. 1995;26:982-989.
6. Detrembleur C, Dierick F, Stoquart G, et al. Energy cost, mechanical work, and efficiency of hemiparetic walking. Gait Posture. 2003;18:47-55.
7. Diller L, Weinberg J. Evidence for accident-prone behavior in hemiple-gic patients. Arch Phys Med Rehabil. 1970;51:358-363.
8. Nyberg L, Gustafson Y. Patient falls in stroke rehabilitation. A challenge to rehabilitation strategies. Stroke. 1995;26:838-842.
9. Malouin F, Potvin M, Prevost J, et al. Use of an intensive task-oriented gait training program in a series of patients with acute cerebrovascular accidents. Phys Ther. 1992;72:781-789; discussion 789-793.
10. Richards CL, Malouin F, Wood-Dauphinee S, et al. Task-specific physical therapy for optimization of gait recovery in acute stroke patients. Arch Phys Med Rehabil. 1993;74:612-620.
11. Miller EW, Quinn ME, Seddon PG. Body weight support treadmill and overground ambulation training for two patients with chronic disability secondary to stroke. Phys Ther. 2002;82:53-61.
12. Dunsky A, Dickstein R, Marcovitz E, et al. Home-based motor imagery training for gait rehabilitation of people with chronic poststroke hemiparesis. Arch Phys Med Rehabil. 2008;89:1580-1588.
13. Husemann B, Muller F, Krewer C, et al. Effects of locomotion training with assistance of a robot-driven gait orthosis in hemiparetic patients after stroke: a randomized controlled pilot study. Stroke. 2007;38:349-354.
14. Hesse S, Uhlenbrock D. A mechanized gait trainer for restoration of gait. J Rehabil Res Dev. 2000;37:701-708.
15. Hesse S, Werner C, Uhlenbrock D, et al. An electromechanical gait trainer for restoration of gait in hemiparetic stroke patients: preliminary results. Neurorehabil Neural Repair. 2001;15:39-50.
16. Whitall J. Stroke rehabilitation research: time to answer more specific questions? Neurorehabil Neural Repair. 2004;18:3- 8; author reply 9 -11.
17. Tong RK, Ng MF, Li LS. Effectiveness of gait training using an electromechanical gait trainer, with and without functional electric stimulation, in subacute stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2006;87:1298-1304.
18. Tong RK, Ng MF, Li LS, et al. Gait training of patients after stroke using an electromechanical gait trainer combined with simultaneous functional electrical stimulation. Phys Ther. 2006;86:1282-1294.
19. Mirelman A, Bonato P, Deutsch JE. Effects of training in robot virtual reality system vs a robot alone on the gait of individuals post stroke. Stroke. In press.
20. Ferraro M, Palazzolo JJ, Krol J, et al. Robot-aided sensorimotor arm training improves outcome in patients with chronic stroke. Neurology. 2003;61:1604-1607.
21. Agrawal SK, Banala SK, Fattah A, et al. Assessment of motion of a swing leg and gait rehabilitation with a gravity balancing exoskeleton. IEEE Trans Neural Syst Rehabil Eng. 2007;15:410-420.
22. Banala SK, Agrawal SK, Fattah A, et al. Gravity-balancing leg orthosis and its performance evaluation. IEEE Trans Robotics. 2006;22:1228-1239.
23. Benoit D, Krishnamoorthy V, Banala SK, et al. An integrated approach for improving gait in a stroke population: combining robotics, FES and neuromusculoskeletal modeling. Presented at: Annual Meeting of American Society of Biomechanics, Blacksburg, VA, 2006.
24. Nudo RJ. Mechanisms for recovery of motor function following cortical damage. Curr Opin Neurobiol. 2006;16:638-644.
25. Macko RF, Ivey FM, Forrester LW, et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial. Stroke. 2005; 36:2206-2211.
26. Bajd T, Kralj A, Sega J, et al. Use of a two-channel functional electrical stimulator to stand paraplegic patients. Phys Ther. 1981;61:526-527.
27. Bajd T, Kralj A, Turk R. Standing-up of a healthy subject and a paraplegic patient. J Biomech. 1982;15:1-10.
28. Agarwal S, Kobetic R, Nandurkar S, et al. Functional electrical stimulation for walking in paraplegia: 17-year follow-up of 2 cases. J Spinal Cord Med. 2003;26:86-91.
29. Kralj A, Bajd T, Turk R. Enhancement of gait restoration in spinal injured patients by functional electrical stimulation. Clin Orthop Relat Res. 1988;233:34-43.
30. Wieler M, Stein RB, Ladouceur M, et al. Multicenter evaluation of electrical stimulation systems for walking. Arch Phys Med Rehabil. 1999;80:495-500.
31. Mangold S, Keller T, Curt A, et al. Transcutaneous functional electrical stimulation for grasping in subjects with cervical spinal cord injury. Spinal Cord. 2005;43:1-13.
32. Binder-Macleod SA, Lee SCK. Assessment of efficacy of functional electrical stimulation in patients with hemiplegia. Top Stroke Rehabil. 1997;3:88-98.
33. Burridge JH, Taylor PN, Hagan SA, et al. The effects of common peroneal stimulation on the effort and speed of walking: a randomized controlled trial with chronic hemiplegic patients. Clin Rehabil. 1997;11: 201-210.
34. Chae J, Yu DT. Neuromuscular electrical stimulation for motor restoration in hemiparesis. Top Stroke Rehabil. 2002;8:24-39.
35. Johnson CA, Burridge JH, Strike PW, et al. The effect of combined use of botulinum toxin type A and functional electric stimulation in the treatment of spastic drop foot after stroke: a preliminary investigation. Arch Phys Med Rehabil. 2004;85:902-909.
36. Kottink AI, Oostendorp LJ, Buurke JH, et al. The orthotic effect of functional electrical stimulation on the improvement of walking in stroke patients with a dropped foot: a systematic review. Artif Organs. 2004;28:577-586.
37. Ring H, Rosenthal N. Controlled study of neuroprosthetic functional electrical stimulation in sub-acute post-stroke rehabilitation. J Rehabil Med. 2005;37:32-36.
38. Taylor PN, Burridge JH, Dunkerley AL, et al. Clinical use of the Odstock dropped foot stimulator: its effect on the speed and effort of walking. Arch Phys Med Rehabil. 1999;80:1577-1583.
39. Voigt M, Sinkjaer T. Kinematic and kinetic analysis of the walking pattern in hemiplegic patients with foot-drop using a peroneal nerve stimulator. Clin Biomech (Bristol, Avon). 2000;15:340-351.
40. Weber DJ, Stein RB, Chan KM, et al. BIONic WalkAide for correcting foot drop. IEEE Trans Neural Syst Rehabil Eng. 2005;13:242-246.
41. Schmidt RA, Lee TD. Motor Control and Learning: A Behavioral Emphasis. Champaign, IL: Human Kinetics, Inc.; 2005.
42. Schmidt RA, Wulf G. Continuous concurrent feedback degrades skill learning: implications for training and simulation. Hum Factors. 1997; 39:509-525.
43. Colarusso RP, Hammill DD. Motor-Free Visual Perception Test (MVPT-3). Novato, CA: Academic Therapy Publications; 2006.
44. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state." A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-198.
45. Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. 1987;67:206-207.
46. Berg KO, Wood-Dauphinee SL, Williams JI, et al. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992; 83(suppl 2):S7-S11.
47. Lindmark B, Hamrin E. Evaluation of functional capacity after stroke as a basis for active intervention. Presentation of a modified chart for motor capacity assessment and its reliability. Scand J Rehabil Med. 1988;20: 103-109.
48. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991; 39:142-148.
49. Herbert RD, Gandevia SC. Twitch interpolation in human muscles: mechanisms and implications for measurement of voluntary activation. J Neurophysiol. 1999;82:2271-2283.
50. Norregaard J, Lykkegaard JJ, Bulow PM, et al. The twitch interpolation technique for the estimation of true quadriceps muscle strength. Clin Physiol (Oxford, England). 1997;17:523-532.
51. Binder-Macleod SA, Kesar T. Catchlike property of skeletal muscle: recent findings and clinical implications. Muscle Nerve. 2005;31:681- 693.
52. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80:896-903.
53. Shumway-Cook A, Woollacott M. Motor Control: Theory and Practical Applications. Baltimore, MD: Williams & Wilkins; 1995.
54. Bogle Thorbahn LD, Newton RA. Use of the Berg Balance Test to predict falls in elderly persons. Phys Ther. 1996;76:576-583; discussion 584-585.
55. Mao HF, Hsueh IP, Tang PF, et al. Analysis and comparison of the psychometric properties of three balance measures for stroke patients. Stroke. 2002;33:1022-1027.
56. Chae J, Yu D. A critical review of neuromuscular electrical stimulation for treatment of motor dysfunction in hemiplegia. Assist Technol. 2000; 12:33-49.
57. de Kroon JR, van der Lee JH, IJzerman MJ, et al. Therapeutic electrical stimulation to improve motor control and functional abilities of the upper extremity after stroke: a systematic review. Clin Rehabil. 2002; 16:350-360.
58. Peckham PH, Knutson JS. Functional electrical stimulation for neuro-muscular applications. Annu Rev Biomed Eng. 2005;7:327-360.
59. Stein RB, Chong S, Everaert DG, et al. A multicenter trial of a footdrop stimulator controlled by a tilt sensor. Neurorehabil Neural Repair. 2006;20:371-379.
60. Glanz M, Klawansky S, Stason W, et al. Functional electrostimulation in poststroke rehabilitation: a meta-analysis of the randomized controlled trials. Arch Phys Med Rehabil. 1996;77:549-553.
61. Sherwood DE, Lee TD. Schema theory: critical review and implications for the role of cognition in a new theory of motor learning. Res Q Exerc Sport. 2003;74:376-382.
62. Hanlon RE. Motor learning following unilateral stroke. Arch Phys Med Rehabil. 1996;77:811-815.
63. Winstein CJ, Merians AS, Sullivan KJ. Motor learning after unilateral brain damage. Neuropsychologia. 1999;37:975-987.