Article

Impairments in gait coordination may be a factor in falls and mobility
limitations after stroke. Therefore, rehabilitation targeting gait coordination
may be an effective way to improve walking post-stroke.
This review sought to
examine current treatments that target impairments of gait coordination, the
theoretical basis on which they are derived and the effects of such
interventions. Few high quality RCTs with a low risk of bias specifically
targeting and measuring restoration of coordinated gait were found. Consequently,
we took a pragmatic approach to describing and quantifying the available evidence
and included non-randomised study designs and limited the influence of
heterogeneity in experimental design and control comparators by restricting
meta-analyses to pre- and post-test comparisons of experimental interventions
only. Results show that physiotherapy interventions significantly improved gait
function and coordination. Interventions involving repetitive task-specific
practice and/or auditory cueing appeared to be the most promising approaches to
restore gait coordination. The fact that overall improvements in gait
coordination coincided with increased walking speed lends support to the
hypothesis that targeting gait coordination gait may be a way of improving
overall walking ability post-stroke. However, establishing the mechanism for
improved locomotor control requires a better understanding of the nature of both
neuroplasticity and coordination deficits in functional tasks after stroke.
Future research requires the measurement of impairment, activity and cortical
activation in an effort to establish the mechanism by which functional gains are
achieved.
CI - Copyright A(c) 2011 Elsevier B.V. All rights reserved.

Langue : ANGLAIS