The role of movement errors in modifying spatiotemporal gait asymmetry post stroke: a randomized controlled trial.
The role of movement errors in modifying spatiotemporal gait asymmetry post stroke: a randomized controlled trial.
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DOI：
10.1177/0269215517723056
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发表时间：
2018-03
影响因子：
3
通讯作者：
Giuliani C
中科院分区：
文献类型：
--
作者：
Lewek MD;Braun CH;Wutzke C;Giuliani C
目前改善中风后步态对称性的康复治疗基于两种相互竞争的运动学习策略之一：最小化或增加对称性误差。我们试图确定哪些运动学习策略最能改善地上时空步态对称性。随机对照试验康复研究实验室将 47 名患有中风后慢性偏瘫和时空步态不对称的参与者（59±12 岁）随机分为误差增大组、误差最小化组或传统跑步机训练（对照）组。为了逐步增强或最小化不对称性，我们开发了一种响应式“闭环”控制系统，使用分体带仪表跑步机，不断调整带速差异，使其与患者当前的不对称性成比例。在 18 次训练之前和之后收集了地面时空不对称性和步态速度。训练后步长不对称性减少，但站立时间却没有。没有小组×时间的互动。训练后步态速度有所改善，但不受不对称类型或群体的影响。在那些接受修正步长不对称训练的人中，步长不对称的变化与步态速度的变化之间存在中等程度的线性关系。在传统跑步机行走过程中，增加错误并不优于最小化错误或仅提供口头反馈。因此，使用口头反馈来针对所有参与者常见的时空不对称性似乎足以减少步长不对称性。在任何组中都没有引起站立时间不对称性的改变。
Current rehabilitation to improve gait symmetry following stroke is based on one of two competing motor learning strategies: minimizing or augmenting symmetry errors. We sought to determine which of those motor learning strategies best improves overground spatiotemporal gait symmetry. randomized controlled trial Rehabilitation research lab 47 participants (59±12 years old) with chronic hemiparesis post-stroke and spatiotemporal gait asymmetry were randomized to error augmentation, error minimization, or conventional treadmill training (control) groups. To augment or minimize asymmetry on a step-by-step basis, we developed a responsive, ‘closed loop’ control system, using a split-belt instrumented treadmill that continuously adjusted the difference in belt speeds to be proportional to the patient's current asymmetry. Overground spatiotemporal asymmetries and gait speeds were collected prior to and following 18 training sessions. Step length asymmetry reduced after training, but stance time did not. There was no group × time interaction. Gait speed improved after training, but was not affected by type of asymmetry, or group. Of those who trained to modify step length asymmetry, there was a moderately strong linear relationship between the change in step length asymmetry and the change in gait speed. Augmenting errors was not superior to minimizing errors or providing only verbal feedback during conventional treadmill walking. Therefore, the use of verbal feedback to target spatiotemporal asymmetry, which was common to all participants, appears to be sufficient to reduce step length asymmetry. Alterations in stance time asymmetry were not elicited in any group.
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影响因子：
4.2
作者：
Awad LN;Palmer JA;Pohlig RT;Binder-Macleod SA;Reisman DS
通讯作者：
Reisman DS
DOI：
10.1109/tnsre.2011.2120623
发表时间：
2011-06
期刊：
IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society
影响因子：
--
作者：
Feasel J;Whitton MC;Kassler L;Brooks FP;Lewek MD
通讯作者：
Lewek MD
影响因子：
2.4
作者：
Patterson, Kara K.;Gage, William H.;McIlroy, William E.
通讯作者：
McIlroy, William E.
DOI：
10.1016/j.apmr.2004.04.034
发表时间：
2005-03-01
影响因子：
4.3
作者：
Norvell, DC;Czerniecki, JM;Weiss, NS
通讯作者：
Weiss, NS
影响因子：
4.1
作者：
Jorgensen, L;Crabtree, NJ;Jacobsen, BK
通讯作者：
Jacobsen, BK