Rehabilitation with accurate adaptability walking tasks or steady state walking: A randomized clinical trial in adults post-stroke.
Objective: To assess changes in walking function and walking-related prefrontal cortical activity following two post-stroke rehabilitation interventions: an accurate adaptability (ACC) walking intervention and a steady state (SS) walking intervention. Design: Randomized, single blind, parallel group...
| Published in: | Clinical Rehabilitation Vol. 35; no. 8; pp. 1196 - 1207 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | research tables/charts randomized controlled trial Journal Article |
| Published: |
Sage Publications Inc.
Aug2021
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=151347490&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 151347490 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02692155 31B jtl: Clinical Rehabilitation issn: 02692155 maglogo: Y pubinfo: dt: Aug2021 vid: 35 iid: 8 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 151347490 149303493 151347490 151347490 10.1177/02692155211001682 151347490 ppf: 1196 ppct: 11 formats: tig: atl: Rehabilitation with accurate adaptability walking tasks or steady state walking: A randomized clinical trial in adults post-stroke. aug: au: Clark, David J Rose, Dorian K Butera, Katie A Hoisington, Brooke DeMark, Louis Chatterjee, Sudeshna A Hawkins, Kelly A Otzel, Dana M Skinner, Jared W Christou, Evangelos A Wu, Samuel S Fox, Emily J affil: Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA sug: subj: Walking Physiology Task Performance and Analysis Stroke Rehabilitation Stroke Patients Human Randomized Controlled Trials Male Female Adult Middle Age Aged Aged, 80 and Over Spectroscopy, Near-Infrared Descriptive Statistics Functional Status Outcome Assessment Clinical Assessment Tools Neuropsychological Tests Questionnaires Scales Funding Source Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Objective: To assess changes in walking function and walking-related prefrontal cortical activity following two post-stroke rehabilitation interventions: an accurate adaptability (ACC) walking intervention and a steady state (SS) walking intervention. Design: Randomized, single blind, parallel group clinical trial. Setting: Hospital research setting. Subjects: Adults with chronic post-stroke hemiparesis and walking deficits. Interventions: ACC emphasized stepping accuracy and walking adaptability, while SS emphasized steady state, symmetrical stepping. Both included 36 sessions led by a licensed physical therapist. ACC walking tasks recruit cortical regions that increase corticospinal tract activation, while SS walking activates the corticospinal tract less intensely. Main measures: The primary functional outcome measure was preferred steady state walking speed. Prefrontal brain activity during walking was measured with functional near infrared spectroscopy to assess executive control demands. Assessments were conducted at baseline, post-intervention (three months), and follow-up (six months). Results: Thirty-eight participants were randomized to the study interventions (mean age 59.6 ± 9.1 years; mean months post-stroke 18.0 ± 10.5). Preferred walking speed increased from baseline to post-intervention by 0.13 ± 0.11 m/s in the ACC group and by 0.14 ± 0.13 m/s in the SS group. The Time × Group interaction was not statistically significant (P = 0.86). Prefrontal fNIRS during walking decreased from baseline to post-intervention, with a marginally larger effect in the ACC group (P = 0.05). Conclusions: The ACC and SS interventions produced similar changes in walking function. fNIRS suggested a potential benefit of ACC training for reducing demand on prefrontal (executive) resources during walking. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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