Week 9

Question 1

Walking training evidence

Answer 1

Strong recommendation:
-For stroke survivors with difficulty walking should be given the opportunity to undertake tailored repetitive practice of walking (or components of walking) as much as possible

The following modalities may be used:

• Circuit class therapy
• Treadmill training with or without body weight support

Question 2

Mehrholz Cochran review on electromechanical training

Answer 2

The use of treadmill training in walking rehabilitation for people after stroke increased the walking velocity and walking endurance

Velocity increased by 0.06m/s and walking endurance was 14.19m

Question 3

Repetitive walking practice for people who cannot walk

Answer 3

-Mechanically assisted walking including TM and BWS lead to more independent walking and better walking speed and distance in stroke patients who could not walk

Question 4

Repetitive walking practice for people who can walk

Answer 4

For people who can walk in their treadmill walking repetitive practice lead to 62m further walked in 6MWT and a 0.18m/s increase in speed

For people who could walk and received cues to increase the their step length lead to an improvement in walking speed and stride length. Also may produce benefits for cadence and symmetry

Recommendation:
-Add 30mins of cueing of cadence to walking training, 4x/week for 4 weeks for moderately disabled individuals with stroke

Question 5

‘As much as possible’

Answer 5

Providing opportunities for people to practice; semi supervised and independent practice

Semi-supervised

• Environment needs to be set up to provide safety and cueing to increase quality
• Need to count and record reps to increase quantity