Dataset Information

Complex versus simple ankle movement training in stroke using telerehabilitation: a randomized controlled trial.

ABSTRACT:

Background

Telerehabilitation allows rehabilitative training to continue remotely after discharge from acute care and can include complex tasks known to create rich conditions for neural change.

Objectives

The purposes of this study were: (1) to explore the feasibility of using telerehabilitation to improve ankle dorsiflexion during the swing phase of gait in people with stroke and (2) to compare complex versus simple movements of the ankle in promoting behavioral change and brain reorganization.

Design

This study was a pilot randomized controlled trial.

Setting

Training was done in the participant's home. Testing was done in separate research labs involving functional magnetic resonance imaging (fMRI) and multi-camera gait analysis.

Patients

Sixteen participants with chronic stroke and impaired ankle dorsiflexion were assigned randomly to receive 4 weeks of telerehabilitation of the paretic ankle.

Intervention

Participants received either computerized complex movement training (track group) or simple movement training (move group).

Measurements

Behavioral changes were measured with the 10-m walk test and gait analysis using a motion capture system. Brain reorganization was measured with ankle tracking during fMRI.

Results

Dorsiflexion during gait was significantly larger in the track group compared with the move group. For fMRI, although the volume, percent volume, and intensity of cortical activation failed to show significant changes, the frequency count of the number of participants showing an increase versus a decrease in these values from pretest to posttest measurements was significantly different between the 2 groups, with the track group decreasing and the move group increasing.

Limitations

Limitations of this study were that no follow-up test was conducted and that a small sample size was used.

Conclusions

The results suggest that telerehabilitation, emphasizing complex task training with the paretic limb, is feasible and can be effective in promoting further dorsiflexion in people with chronic stroke.

SUBMITTER: Deng H

PROVIDER: S-EPMC3269771 | biostudies-literature | 2012 Feb

REPOSITORIES: biostudies-literature

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Publications

Complex versus simple ankle movement training in stroke using telerehabilitation: a randomized controlled trial.

Deng Huiqiong H Durfee William K WK Nuckley David J DJ Rheude Brandon S BS Severson Amy E AE Skluzacek Katie M KM Spindler Kristen K KK Davey Cynthia S CS Carey James R JR

Physical therapy 20111117 2

<h4>Background</h4>Telerehabilitation allows rehabilitative training to continue remotely after discharge from acute care and can include complex tasks known to create rich conditions for neural change.<h4>Objectives</h4>The purposes of this study were: (1) to explore the feasibility of using telerehabilitation to improve ankle dorsiflexion during the swing phase of gait in people with stroke and (2) to compare complex versus simple movements of the ankle in promoting behavioral change and brain ...[more]

PMID: 22095209

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Project description:BackgroundAn unsettled question in the use of robotics for post-stroke gait rehabilitation is whether task-specific locomotor training is more effective than targeting individual joint impairments to improve walking function. The paretic ankle is implicated in gait instability and fall risk, but is difficult to therapeutically isolate and refractory to recovery. We hypothesize that in chronic stroke, treadmill-integrated ankle robotics training is more effective to improve gait function than robotics focused on paretic ankle impairments.FindingsParticipants with chronic hemiparetic gait were randomized to either six weeks of treadmill-integrated ankle robotics (n = 14) or dose-matched seated ankle robotics (n = 12) videogame training. Selected gait measures were collected at baseline, post-training, and six-week retention. Friedman, and Wilcoxon Sign Rank and Fisher's exact tests evaluated within and between group differences across time, respectively. Six weeks post-training, treadmill robotics proved more effective than seated robotics to increase walking velocity, paretic single support, paretic push-off impulse, and active dorsiflexion range of motion. Treadmill robotics durably improved gait dorsiflexion swing angle leading 6/7 initially requiring ankle braces to self-discarded them, while their unassisted paretic heel-first contacts increased from 44 % to 99.6 %, versus no change in assistive device usage (0/9) following seated robotics.ConclusionsTreadmill-integrated, but not seated ankle robotics training, durably improves gait biomechanics, reversing foot drop, restoring walking propulsion, and establishing safer foot landing in chronic stroke that may reduce reliance on assistive devices. These findings support a task-specific approach integrating adaptive ankle robotics with locomotor training to optimize mobility recovery.Clinical trial identifierNCT01337960. https://clinicaltrials.gov/ct2/show/NCT01337960?term=NCT01337960&rank=1.

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Dataset Information

Complex versus simple ankle movement training in stroke using telerehabilitation: a randomized controlled trial.

Background

Objectives

Design

Setting

Patients

Intervention

Measurements

Results

Limitations

Conclusions

Publications

Complex versus simple ankle movement training in stroke using telerehabilitation: a randomized controlled trial.

Similar Datasets

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