Interventions for coordination of walking following stroke: Systematic review

Have these interventions risen to the level of a protocol in the last 9 years? If not, A HELL OF A LOT OF PEOPLE NEED TO BE FIRED, starting with stroke department heads from every stroke hospital. Because if they aren't changing the failure of the status quo, they are not leaders and shouldn't be in positions of authority. This is what stroke leaders should be solving:

Maybe you want researchers to solve these problems in stroke, or this nihilism list.

Interventions for coordination of walking following stroke: Systematic review

  KristenL.Hollands a,
*,TrudyA. Pelton b,
SarahF.Tyson a,
MarkA. Hollands c,
Paulette M. van Vliet d
a.  School of Health, Sport and Rehabilitation Sciences,University of Salford,Frederick Rd.Campus,Salford M66PU, UK .
b.  School of Psychology,College of Life and Environmental Sciences,University of Birmingham, UK c.  School of Sport and Exercise Sciences,College of Life and Environmental Sciences,University of Birmingham, UK 
d.  School of Health Sciences,University of Newcastle,  Australia
Article history:
Received: 5 May 2011
Received in revised form, 20 July 2011
Accepted: 22 October 2011

 ABSTRACT

Impairments in gait coordination may be a factor in falls and mobility limitations after stroke.

Therefore, rehabilitation targeting gait coordination may be an effective way to improve walking post stroke.  This review sought to examine current treatments that target impairments of gait coordination, the theoretical basis on which they are derived and the effects of such interventions. Few high quality RCTs with a low risk of bias specifically targeting and measuring restoration of coordinated gait were found.(Well then, create such research. Do you expect survivors to recover with the crapola they have today?) Consequently, we took a pragmatic approach to describing and quantifying the available evidence and included non-randomised study designs and limited the influence of heterogeneity in experimental design and control comparators by restricting meta-analyses to pre- and post-test comparisons of experimental interventions only. Results show that physiotherapy interventions significantly improved gait function and coordination.  Interventions involving repetitive task specific practice and/or auditory cueing appeared to be the most promising approaches to restore gait coordination. The fact that overall improvements in gait coordination coincided with increased walking speed lends support to the hypothesis that targeting gait coordination gait may be a way of improving overall walking ability post stroke.However, establishing the mechanism for improved locomotor control requires a better understanding of the nature of both neuroplasticity and coordination deficits in functional tasks after stroke.  Future research requires the measurement of  impairment, activity and cortical activation in an effort to establish the mechanism by which functional gains are achieved.
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