Gait pattern of severely disabled hemiparetic subjects on a new controlled gait trainer as compared to assisted treadmill walking with partial body weight support. 1999

S Hesse, and D Uhlenbrock, and T Sarkodie-Gyan
Klinik Berlin, Department of Neurological Rehabilitation, Free University Berlin, Germany. bhesse@mail.zedat.fu-berlin.de

OBJECTIVE To investigate to what extent and with how much therapeutic effort nonambulatory stroke patients could train a gait-like movement on a newly developed, machine-supported gait trainer. METHODS Open study comparing the movement on the gait trainer with assisted walking on the treadmill. METHODS Motion analysis laboratory of a rehabilitation centre. METHODS Fourteen chronic, nonambulatory hemiparetic patients. METHODS Complex gait analysis while training on the gait trainer and while walking on the treadmill. METHODS Gait kinematics, kinesiological EMG of several lower limb muscles and the required assistance. RESULTS Patients could train a gait-like movement on the gait trainer, characterized kinematically by a perfect symmetry, larger hip extension during stance, less knee flexion and less ankle plantar flexion during swing as compared to treadmill walking (p <0.01). The pattern and amount of activation of relevant weight-bearing muscles was comparable with an even larger activation of the M. biceps femoris on the gait trainer (p <0.01). The tibialis anterior muscle of the nonaffected side, however, was less activated during swing (p <0.01). Two therapists assisted walking on the treadmill while only one therapist was necessary to help with weight shifting on the new device. CONCLUSIONS The newly developed gait trainer offered severely disabled hemiparetic subjects the possibility of training a gait-like, highly symmetrical movement with a favourable facilitation of relevant anti-gravity muscles. At the same time, the effort required of the therapists was reduced.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004576 Electromyography Recording of the changes in electric potential of muscle by means of surface or needle electrodes. Electromyogram,Surface Electromyography,Electromyograms,Electromyographies,Electromyographies, Surface,Electromyography, Surface,Surface Electromyographies
D005260 Female Females
D005684 Gait Manner or style of walking. Gaits
D006112 Gravitation Acceleration produced by the mutual attraction of two masses, and of magnitude inversely proportional to the square of the distance between the two centers of mass. It is also the force imparted by the earth, moon, or a planet to an object near its surface. (From NASA Thesaurus, 1988) G Force,Gravistimulation,Gravity,Force, G,G Forces,Gravities
D006233 Disabled Persons Persons with physical or mental disabilities that affect or limit their activities of daily living and that may require special accommodations. Handicapped,People with Disabilities,Persons with Disabilities,Physically Challenged,Physically Handicapped,Physically Disabled,Disabilities, People with,Disabilities, Persons with,Disability, Persons with,Disabled Person,Disabled, Physically,Handicapped, Physically,People with Disability,Person, Disabled,Persons with Disability,Persons, Disabled
D006429 Hemiplegia Severe or complete loss of motor function on one side of the body. This condition is usually caused by BRAIN DISEASES that are localized to the cerebral hemisphere opposite to the side of weakness. Less frequently, BRAIN STEM lesions; cervical SPINAL CORD DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; and other conditions may manifest as hemiplegia. The term hemiparesis (see PARESIS) refers to mild to moderate weakness involving one side of the body. Monoplegia,Hemiplegia, Crossed,Hemiplegia, Flaccid,Hemiplegia, Infantile,Hemiplegia, Post-Ictal,Hemiplegia, Spastic,Hemiplegia, Transient,Crossed Hemiplegia,Crossed Hemiplegias,Flaccid Hemiplegia,Flaccid Hemiplegias,Hemiplegia, Post Ictal,Hemiplegias,Hemiplegias, Crossed,Hemiplegias, Flaccid,Hemiplegias, Infantile,Hemiplegias, Post-Ictal,Hemiplegias, Spastic,Hemiplegias, Transient,Infantile Hemiplegia,Infantile Hemiplegias,Monoplegias,Post-Ictal Hemiplegia,Post-Ictal Hemiplegias,Spastic Hemiplegia,Spastic Hemiplegias,Transient Hemiplegia,Transient Hemiplegias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000071939 Stroke Rehabilitation Restoration of functions to the maximum degree possible in a person or persons suffering from a stroke. Rehabilitation, Stroke

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