How are you going to set this up so all 10 million yearly stroke survivors can take advantage of it? Is it better than action observation?
Home-Based Motor Imagery Training for Gait Rehabilitation of People With Chronic Poststroke Hemiparesis
Ayelet Dunsky, PhD, Ruth Dickstein, DSc, Emanuel Marcovitz, MD, Sandra Levy, MA, Judith Deutsch, PT, PhD
ArchPhys Med Rehabil 2008;89:1580-8.
ArchPhys Med Rehabil 2008;89:1580-8.
ABSTRACT.
Objective:
To test the feasibility and efficacy of a home based motor imagery gait training program to improve walking performance of individuals with chronic post stroke hemiparesis.
Design:
Nonrandomized controlled trial.
Setting:
Local facility.
Participants:
Participants (N
17) were community dwelling volunteers with hemiparesis caused by a unilateral stroke that occurred at least 3 months before the study.
Intervention:
Participants received 15 minutes of supervised imagery gait training in their homes 3 days a week for 6 weeks. The intervention addressed gait impairments of the affected lower limb and task specific gait training. Walking ability was evaluated by kinematics and functional scales twice before the intervention, 3 and 6 weeks after the intervention began, and at the 3-week follow-up.
Main Outcome Measures:
Spatiotemporal, kinematic, and functional walking measurements.
Results:
Walking speed increased significantly by 40% after training, and the gains were largely maintained at the 3-week follow-up. The effect size of the intervention on walking speed was moderate (.64). There were significant increases in stride length, cadence, and single-support time of the affected lower limb, whereas double-support time was decreased. Improvements were also noted on the gait scale of the Tinetti Performance-Oriented Mobility Assessment as well as in functional gait. Sixty-five percent of the participants advanced 1 walking category in the Modified Functional Walking Categories Index.
Conclusions:
Although further study is recommended, the findings support the feasibility and justify the incorporation of home-based motor imagery exercises to improve walking skills for post stroke hemiparesis.
Key Words:
Gait; Hemiparesis; Home care services; Rehabilitation; Stroke.©
2008 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation
To test the feasibility and efficacy of a home based motor imagery gait training program to improve walking performance of individuals with chronic post stroke hemiparesis.
Design:
Nonrandomized controlled trial.
Setting:
Local facility.
Participants:
Participants (N
17) were community dwelling volunteers with hemiparesis caused by a unilateral stroke that occurred at least 3 months before the study.
Intervention:
Participants received 15 minutes of supervised imagery gait training in their homes 3 days a week for 6 weeks. The intervention addressed gait impairments of the affected lower limb and task specific gait training. Walking ability was evaluated by kinematics and functional scales twice before the intervention, 3 and 6 weeks after the intervention began, and at the 3-week follow-up.
Main Outcome Measures:
Spatiotemporal, kinematic, and functional walking measurements.
Results:
Walking speed increased significantly by 40% after training, and the gains were largely maintained at the 3-week follow-up. The effect size of the intervention on walking speed was moderate (.64). There were significant increases in stride length, cadence, and single-support time of the affected lower limb, whereas double-support time was decreased. Improvements were also noted on the gait scale of the Tinetti Performance-Oriented Mobility Assessment as well as in functional gait. Sixty-five percent of the participants advanced 1 walking category in the Modified Functional Walking Categories Index.
Conclusions:
Although further study is recommended, the findings support the feasibility and justify the incorporation of home-based motor imagery exercises to improve walking skills for post stroke hemiparesis.
Key Words:
Gait; Hemiparesis; Home care services; Rehabilitation; Stroke.©
2008 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation
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