http://nnr.sagepub.com/content/28/1/45.abstract?etoc
- I-Hsuan Chen, PhD1
- Yea-Ru Yang, PhD1,2
- Rai-Chi Chan, MD3
- Ray-Yau Wang, PhD1
- 1National Yang-Ming University, Taipei, Taiwan
- 2Taipei City Hospital, Taipei, Taiwan
- 3Taipei Veterans General Hospital, Taipei, Taiwan
- Ray-Yau Wang, PhD, Department of Physical Therapy and Assistive Technology, National Yang-Ming University, 155, Sec. 2, Li-Nong Street, Beitou District, Taipei 112, Taiwan. Email: rywang@ym.edu.tw
Abstract
Background. Turning is a challenging task
for stroke patients. Programs that effectively target turning, however,
have not been established.
Objective. This study examined the effects of a novel turning-based treadmill training on turning performance, gait symmetry, balance,
and muscle strength in patients with chronic stroke. Methods.
Thirty participants were randomly assigned to the experimental group
that received 30 minutes of turning-based treadmill
training or to the control group that received 30
minutes of regular treadmill training, followed by a 10-minute general
exercise
program for 12 sessions over 4 weeks. Primary
outcomes (overground turning speed and temporal–spatial characteristics
of straight
walking) and secondary outcomes (balance and muscle
strength) were assessed at baseline, after training, and at 1-month
follow-up.
Results. Fifteen participants per group
were 54.2 ± 9.6 years old, poststroke 2.6 ± 1.9 years, and walked
overground at 0.59 ± 0.28
m/s. Sixteen had an ischemic and 14 a hemorrhagic
stroke. There were significant interaction effects between groups and
time
on turning speed regardless of turning direction,
straight-walking performance (speed and temporal symmetry), strength of
hip muscles and ankle dorsiflexors, and balance
control (Berg Balance Scale, weight shifting in the forward direction
and
vestibular function). Compared with the control
group, the experimental group showed greater improvements in these
measures
following training. These improvements persisted at
the 1-month follow-up evaluation. Conclusions. Turning-based treadmill training may be a feasible and effective strategy to improve turning ability, gait symmetry, muscle
strength, and balance control for individuals with chronic stroke.
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