|Generate QR code
Open Access
Subscription Access
Effectiveness of walking training in patients with central hemiparesis
https://doi.org/10.30629/2658-7947-2024-29-6-44-50
Abstract
Improving walking remains the most important goal of rehabilitation, and the effectiveness of previously proposed methods of practicing the motor skill requires further improvement.
The aim of the work is to evaluate the results of walking training according to «the period of support» in the comprehensive rehabilitation of patients with central hemiparesis in the early recovery period of ischemic stroke, as well as to identify factors concomitant with gait improvement.
Material and methods. 49 patients with central hemiparesis (mild and moderate in the foot) in the early recovery period of ischemic stroke were examined. The patients were randomized into the main group of 28 patients and the comparison group of 21 patients. The patients of the main group in addition to the standards of care were trained with visual biofeedback on the period of support. Functional testing, assessment of biomechanical indicators of walking and taking surface electromyograms from the thigh and lower leg muscles were performed twice. The training course consisted of 10 sessions of 15 [10;20] minutes each.
Results. Training with the use of biofeedback in patients in the early recovery period of stroke was accompanied by improvement of walking as a daily activity and optimization of biomechanical indices of support period, step cycle length, double support, lateral deviation of the foot, as well as neurophysiological — EMG amplitude of EMG m.Quadriceps femoris.
Conclusion. In patients with central hemiparesis in the early recovery period of ischemic stroke, walking training was accompanied by its improvement simultaneously with an increase in the dynamic component of balance.
About the Authors
I. P. Yastrebtseva
Ivanovo State Medical University; N.I. Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Ivanovo
Moscow
K. A. Manukyan
Ivanovo State Medical University
Russian Federation
Russian Federation
Ivanovo
E. L. Shumarina
Ivanovo State Medical University
Russian Federation
Russian Federation
Ivanovo
V. V. Belova
Ivanovo State Medical University
Russian Federation
Russian Federation
Ivanovo
References
1. Kaźmierczak K., Wareńczak-Pawlicka A., Miedzyblocki M., Lisiński P. Effect of Treadmill Training with Visual Biofeedback on Selected Gait Parameters in Subacute Hemiparetic Stroke Patients. Int J Environ Res Public Health.2022;19(24):16925. https://doi.org/10.3390/ijerph192416925
2. Roelker S.A., Bowden M.G., Kautz S.A., Neptune R.R. Paretic propulsion as a measure of walking performance and functional motor recovery post-stroke: A review. Gait Posture. 2019;68:6–14. https://doi.org/10.1016/j.gaitpost.2018.10.027
3. Padmanabhan P., Rao K.S., Gulhar S., Cherry-Allen K.M. Persons post-stroke improve step length symmetry by walking asymmetrically. J Neuroeng Rehabil. 2020;17(1):105. https://doi.org/10.1186/s12984-020-00732-z
4. Skvortsov D.V. Clinical analysis of movements. Analysis of gait. Ivanovo: Stimul.1996;65-77. (Russian). ISBN 5-86139-066-5. https://rehabrus.ru/Docs/kniga_Skvorcov_DV_Analiz_Pohodki.pdf?ysclid=ltmyj41bl425749104
5. Spencer J., Wolf S.L., Kesar T.M. Biofeedback for Post-stroke GAIT Retraining: A review of current evidence and future research directions in the context of emerging technologies. Front Neurol.2021;12.1-12. https://doi.org/10.3389/fneur.2021.637199
6. Liu J., Kim H.B., Wolf S.L., Kesar T.M. Comparison of the immediate effects of Audio, Visual, or Audiovisual GAIT biofeedback on propulsive force generation in Able-Bodied and Post-stroke individuals. Appl Psychophysiol Biofeedback. 2020;45(3):211–220. https://doi.org/10.1007/s10484-020-09464-1
7. Nigamadianov N.R., Tsykunov M.B., Ivanova G.E., Lukianov V.I. The effectiveness of training with biological feed back by supporting reaction in posture defects in children. Bulletin of Ivanovo Medical Academy. 2017;22(2):21–25.(Russian). https://cyberleninka.ru/article/n/effektivnost-trenirovki-s-biologicheskoy-obratnoy-svyazyu-po-opornoy-reaktsii-pri-defektah-osanki-u-detey/viewer.
8. Van der Ploeg R.J., Oosterhuis H.J., Reuvekamp J. Measuring muscle strength. J Neurol. 1984;231(4):200–203. https://doi.org/10.1007/BF00313939
9. Bohannon R.W., Smith M.B. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. Feb,1987;67(2):206–207. https://doi.org/10.1093/ptj/67.2.206
10. Bohannon R.W. Objective measures. Phys Ther.1989;69(7):590–593. https://doi.org/10.1093/ptj/69.7.590.
11. Berg K., WoodDauphine S., Williams J., Gayton D. Measuring balance in the elderly: preliminary development of an instrument. PhysiotherCan. 1989;41(6):304–311. https://doi.org/10.3138/ptc.41.6.304
12. Hauser S.L., Dawson D.M., Lehrich J.R., Beal M.F., Kevy S.V., Propper R.D., Mills J.A., Weiner H.L. Intensive immunosuppression in progressive multiple sclerosis. A randomized, three-arm study of high-dose intravenous cyclophosphamide, plasma exchange, and ACTH. N Engl J Med. 1983;308(4):173–180. https://doi.org/10.1056/NEJM198301273080401
13. Collen F.M., Wade D.T., Robb G.F., Bradshaw C.M. The Rivermead Mobility Index: a further development of the Rivermead Motor Assessment. Int Disabil Stud. 1991;13(2):50–54. https:// doi.org/10.3109/03790799109166684
14. Williams A. EuroQol: a new facility for the measurement of health-related quality of life. Health Policy. 1990.16(3):199–208. https://doi.org/10.1016/0168-8510(90)90421-9
15. Mańdziuk M., Krawczyk-Suszek M., Maciejewski R., Bednarski J., Kotyra A., Cyganik W. The Application of Biological Feedback in the Rehabilitation of Patients after Ischemic Stroke. Sensors (Basel). 2022;22(5):1769. https://doi.org/10.3390/s22051769
16. Skvortsov D.V., Kaurkin S.N., Ivanova G.E., Polyaev B.B., Bulatova M.A. Targeted Walking Training of Patients in the Early Recovery Period of Cerebral Stroke (Preliminary Research). Journal of Clinical Practice. 2021;12(4):12–22 (Russian). https://doi.org/10.17816/clinpract77334
17. Peurala S.H., Karttunen A.H., Sjögren T., Paltamaa J., Heinonen A. Evidence for the effectiveness of walking training on walking and self-care after stroke: A systematic review and meta-analysis of randomized controlled trials. Journal of Rehabilitation Medicine. 2014;46(5):387–399. https://doi.org/10.2340/16501977-1805
18. Drużbicki M., Guzik A., Przysada G., Kwolek A., Brzozowska-Magoń A., Sobolewski M. Changes in Gait Symmetry After Training on a Treadmill with Biofeedback in Chronic Stroke Patients: A 6-Month Follow-Up From a Randomized Controlled Trial. Med Sci Monit. 2016;22:4859–4868. https://doi.org/10.12659/msm.898420
19. Bishnoi A., Shankar M., Lee R., Yang H., Hernandez M.E. Effects of therapeutic intervention on spatiotemporal GAIT parameters in adults with neurologic Disorder: systematic review and meta-analysis. Arch Phys Med Rehabil. 2023;104(3):451–474. https://doi.org/10.1016/j.apmr.2022.06.003
20. Hyun S.J., Liu J., Lee B.H.. The Effects of Sit-to-Stand Training Combined with Real-Time Visual Feedback on Strength, Balance, Gait Ability, and Quality of Life in Patients with Stroke: A Randomized Controlled Trial. Int J Environ Res Public Health. 2021;18(22):12229. https://doi.org/10.3390/ijerph182212229
21. Zaborova V., Fesyun A., Gurevich K., Oranskaya A., Rylsky A., Kryuchkova K., Malakhovskiy V., Shestakov D. Changes in kinesiostabilogram parameters and movement speed of stroke patients while increasing their physical activity due to the use of biofeedback method. Eur J Transl Myol. 2021;31(4). https://doi.org/10.4081/ejtm.2021.9360
22. Mizuta N., Hasui N., Nakatani T., Takamura Y., Fujii Sh., Tsutsumi M., Taguchi J., Morioka Sh. Walking characteristics including mild motor paralysis and slow walking speed in poststroke patients. Sci Rep. 2020;10(1). https://doi.org/10.1038/s41598-020-68905-3
Review
For citations:
Yastrebtseva I.P., Manukyan K.A., Shumarina E.L., Belova V.V. Effectiveness of walking training in patients with central hemiparesis. Russian neurological journal. 2024;29(6):44-50. (In Russ.) https://doi.org/10.30629/2658-7947-2024-29-6-44-50
Views:
218
Email this article 