The tyranny of low expectations in full flower here; 'improve', improved', 'improving'. NOT RETURN TO NORMAL GAIT!
Only 8 years ago. DID ANYTHING HERE GET TRANSLATED TO STROKE PROTOCOLS AT YOUR HOSPITAL? If not, then firings need to start at the top with the board of directors.
Interventions for coordination of walking following stroke: Systematic review
2012, Gait & Posture
Kristen L.Hollands a,*,
Kristen L.Hollands a,*,
TrudyA. Pelton b,
Sarah F. Tyson a,
Mark A. Hollands c,
Paulette M. vanVliet 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
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
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. 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.
2011ElsevierB.V.All rights reserved.
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. 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.
2011ElsevierB.V.All rights reserved.
No comments:
Post a Comment