Article

OBJECTIVE: To compare the effect of visual and kinesthetic locomotor imagery
training on walking performance and to determine the clinical feasibility of
incorporating auditory step rhythm into the training. DESIGN: Randomized
crossover trial. SETTING: Laboratory of a Department of Physical Therapy.
Fifteen subjects with post-stroke hemiparesis. INTERVENTION: Four
locomotor imagery trainings on walking performance: visual locomotor imagery
training, kinesthetic locomotor imagery training, visual locomotor imagery
training with auditory step rhythm and kinesthetic locomotor imagery training
with auditory step rhythm. MAIN OUTCOME MEASURES: The timed up-and-go test and
electromyographic and kinematic analyses of the affected lower limb during one
gait cycle. RESULTS: After the interventions, significant differences were found
in the timed up-and-go test results between the visual locomotor imagery training
(25.69 +/- 16.16 to 23.97 +/- 14.30) and the kinesthetic locomotor imagery
training with auditory step rhythm (22.68 +/- 12.35 to 15.77 +/- 8.58) (P <
0.05). During the swing and stance phases, the kinesthetic locomotor imagery
training exhibited significantly increased activation in a greater number of
muscles and increased angular displacement of the knee and ankle joints compared
with the visual locomotor imagery training, and these effects were more prominent
when auditory step rhythm was integrated into each form of locomotor imagery
training. The activation of the hamstring during the swing phase and the
gastrocnemius during the stance phase, as well as kinematic data of the knee
joint, were significantly different for posttest values between the visual
locomotor imagery training and the kinesthetic locomotor imagery training with
auditory step rhythm (P < 0.05). CONCLUSIONS: The therapeutic effect may be
further enhanced in the kinesthetic locomotor imagery training than in the visual
locomotor imagery training. The auditory step rhythm together with the locomotor
imagery training produces a greater positive effect in improving the walking
performance of patients with post-stroke hemiparesis.

Langue : ANGLAIS