Locomotor Training Post Stroke Flashcards
Acutely up to ____ of patients with stroke lose the ability to walk independently
80%
At 3 months post stroke, what percentage of patients with stroke require assistance or supervision?
33%
What are common gait abnormalities post stroke?
Decrease in speed
Decrease in cadence
Increase width of BOS
Increase double support time
What asymmetries does the hemiparetic leg show during gait?
Increase in step length
Decrease in stance time with possible knee hyperextension
Decrease in weight bearing
What is average walking speed post stroke?
0.5-1 mph
What is the best predictor of functional ambulation status post stroke?
Gait velocity
What gait speed correlates to household ambulation?
< 0.4 m/s or 1 mph
What gait speed correlates to limited community ambulation?
0.4-.8 m/s or 1.2 mph
What gait speed correlates to unlimited community ambulation?
> 0.8 m/s or 1.8 mph
What gait speed correlates to crossing a street during a red light?
0.5-0.8 m/s or 1-1.8 mph
What is the range of gait velocity post-stroke?
0.25-0.5 m/s or 0.5-1 mph
Recovery of locomotion is best correlated with what?
Strength of distal muscles
Walking speed is the ___ vital sign
6th
How many feet indicates restriction inside the house?
60 feet
How many feet indicates the capability to walk outside to the sidewalk and back?
150 feet
How many feet indicates the capability to go to the grocery store?
1000 feet minimum
_____________ can be loaded through the hemiplegic leg when standing on a postural platform
Less than 40% of body weight
What were the results of Richards study in 1993 on walking training for patients with stroke?
Specificity of training was more important than total training time
What were the results of Sullivan’s study in 2002 on walking training for patients with stroke?
Training speeds closest to normal walking speed were most effective in improving self-selected velocity
What is the mechanism of effectiveness of BWSTT in chronic stroke according to Enzinger’s 2009 study?
Walking improvements are associated with cortical activation changes
According to Cruz’s study in 2009, gait velocity is positively associated with…
hip extensor strength
According to Cruz’s study in 2009, hip extension and flexion and knee flexion strength were associated with…
Therefore…
Reduced frontal plane pelvic compensations
Strengthen hip flexors/extensors and knee flexors
According to Cruz’s study in 2009, multi-joint coupling was associated with…
Therefore…
Increased compensatory pelvic movement at toe-off
Fractionate hip and knee movements
When it comes to the time course of gait changes post stroke, Reisman’s study in 2013 found that…
Biomechanical measures improve and plateau at 4 weeks and functional measures improve through 12 weeks of training
Based on Reisman’s study in 2013, what goals should be given and at what time?
Set biomechanical goals until 4 weeks and continue to improve functional goals through 12 weeks
When it comes to treatment parameters with BWSTT, what is the frequency?
3x per week
When it comes to treatment parameters with BWSTT, what is the intensity?
Starting at a max of 40% unweighting and progressing to 0% as tolerated
When it comes to treatment parameters with BWSTT, what is the duration?
Starting as tolerated with rest as needed (2x2 mins) and progressing to 20 mins
When it comes to treatment parameters with BWSTT, what is the assistance parameters?
One person to assist involved LE and one person to assist in stabilizing trunk
