Locomotor Training Post Stroke

Question 1

Acutely up to ____ of patients with stroke lose the ability to walk independently

Answer 1

80%

Question 2

At 3 months post stroke, what percentage of patients with stroke require assistance or supervision?

Answer 2

33%

Question 3

What are common gait abnormalities post stroke?

Answer 3

Decrease in speed
Decrease in cadence
Increase width of BOS
Increase double support time

Question 4

What asymmetries does the hemiparetic leg show during gait?

Answer 4

Increase in step length
Decrease in stance time with possible knee hyperextension
Decrease in weight bearing

Question 5

What is average walking speed post stroke?

Answer 5

0.5-1 mph

Question 6

What is the best predictor of functional ambulation status post stroke?

Answer 6

Gait velocity

Question 7

What gait speed correlates to household ambulation?

Answer 7

< 0.4 m/s or 1 mph

Question 8

What gait speed correlates to limited community ambulation?

Answer 8

0.4-.8 m/s or 1.2 mph

Question 9

What gait speed correlates to unlimited community ambulation?

Answer 9

> 0.8 m/s or 1.8 mph

Question 10

What gait speed correlates to crossing a street during a red light?

Answer 10

0.5-0.8 m/s or 1-1.8 mph

Question 11

What is the range of gait velocity post-stroke?

Answer 11

0.25-0.5 m/s or 0.5-1 mph

Question 12

Recovery of locomotion is best correlated with what?

Answer 12

Strength of distal muscles

Question 13

Walking speed is the ___ vital sign

Answer 13

6th

Question 14

How many feet indicates restriction inside the house?

Answer 14

60 feet

Question 15

How many feet indicates the capability to walk outside to the sidewalk and back?

Answer 15

150 feet

Question 16

How many feet indicates the capability to go to the grocery store?

Answer 16

1000 feet minimum

Question 17

_____________ can be loaded through the hemiplegic leg when standing on a postural platform

Answer 17

Less than 40% of body weight

Question 18

What were the results of Richards study in 1993 on walking training for patients with stroke?

Answer 18

Specificity of training was more important than total training time

Question 19

What were the results of Sullivan’s study in 2002 on walking training for patients with stroke?

Answer 19

Training speeds closest to normal walking speed were most effective in improving self-selected velocity

Question 20

What is the mechanism of effectiveness of BWSTT in chronic stroke according to Enzinger’s 2009 study?

Answer 20

Walking improvements are associated with cortical activation changes

Question 21

According to Cruz’s study in 2009, gait velocity is positively associated with…

Answer 21

hip extensor strength

Question 22

According to Cruz’s study in 2009, hip extension and flexion and knee flexion strength were associated with…

Therefore…

Answer 22

Reduced frontal plane pelvic compensations

Strengthen hip flexors/extensors and knee flexors

Question 23

According to Cruz’s study in 2009, multi-joint coupling was associated with…

Therefore…

Answer 23

Increased compensatory pelvic movement at toe-off

Fractionate hip and knee movements

Question 24

When it comes to the time course of gait changes post stroke, Reisman’s study in 2013 found that…

Answer 24

Biomechanical measures improve and plateau at 4 weeks and functional measures improve through 12 weeks of training

Question 25

Based on Reisman’s study in 2013, what goals should be given and at what time?

Answer 25

Set biomechanical goals until 4 weeks and continue to improve functional goals through 12 weeks

Question 26

When it comes to treatment parameters with BWSTT, what is the frequency?

Answer 26

3x per week

Question 27

When it comes to treatment parameters with BWSTT, what is the intensity?

Answer 27

Starting at a max of 40% unweighting and progressing to 0% as tolerated

Question 28

When it comes to treatment parameters with BWSTT, what is the duration?

Answer 28

Starting as tolerated with rest as needed (2x2 mins) and progressing to 20 mins

Question 29

When it comes to treatment parameters with BWSTT, what is the assistance parameters?

Answer 29

One person to assist involved LE and one person to assist in stabilizing trunk