Wrong focus. What rehab protocol creates a faster walking speed?
Walking Speed Following Stroke a Good Predictor of Recovery?
Walking speed after stroke may help predict which patients will show greater post-rehab improvement in their ability to simultaneously walk and perform a second task, suggests new research backed by imaging data.
In secondary analysis of a previous study, training enabled both "good" and "limited" walkers to increase travel distance during a 2-minute walk. However, for "dual-task" walking, good walkers improved their distance by approximately 10 m after training, whereas limited walkers improved by only 1 m.
Brain imaging showed increased brain activity in the limited walkers, which could reduce cognitive resources available for performing a second task while walking.
These findings may explain the apparent lack of superiority shown previously of dual-task training compared with single-task training for patients with stroke and impaired walking ability, researchers note.
"Imaging data were consistent with our hypothesis that walking automaticity might explain these results," lead author Johnny Collett, PhD, senior clinical research fellow at Oxford Brookes University, Oxford, United Kingdom, told Medscape Medical News.
At baseline, participants who walked slowly had increased resting state connectivity between contralesional M1 and cortical areas associated with conscious gait control.
"In response to the intervention, we found increased connectivity with the precuneus in those who walked slowly at baseline, an adaptation that might support walking in more complex situations," Collett said.
The findings were published online May 30 in Clinical Rehabilitation.
Benefits Questioned
After stroke, many patients have difficulty walking while performing a second task, such as holding a conversation. Training in dual-task walking has provided uncertain benefits, according to clinical research.
No comments:
Post a Comment