Article

Optimal physical therapy strategies to maximize locomotor function in
patients early poststroke are not well established. Emerging data indicate that
substantial amounts of task-specific stepping practice may improve locomotor
function, although stepping practice provided during inpatient rehabilitation is
limited (<300 steps/session).
The purpose of this investigation was to
determine the feasibility of providing focused stepping training to patients
early poststroke and its potential association with walking and other mobility
outcomes. METHODS: Daily stepping was recorded on 201 patients <6 months
poststroke (80% < 1 month) during inpatient rehabilitation following
implementation of a focused training program to maximize stepping practice during
clinical physical therapy sessions. Primary outcomes included distance and
physical assistance required during a 6-minute walk test (6MWT) and balance using
the Berg Balance Scale (BBS). Retrospective data analysis included multiple
regression techniques to evaluate the contributions of demographics, training
activities, and baseline motor function to primary outcomes at discharge.
RESULTS: Median stepping activity recorded from patients was 1516 steps/d, which
is 5 to 6 times greater than that typically observed. The number of steps per day
was positively correlated with both discharge 6MWT and BBS and improvements from
baseline (changes; r = 0.40-0.87), independently contributing 10% to 31% of the
total variance. Stepping activity also predicted level of assistance at discharge
and discharge location (home vs other facility). CONCLUSION: Providing focused,
repeated stepping training was feasible early poststroke during inpatient
rehabilitation and was related to mobility outcomes. Further research is required
to evaluate the effectiveness of these training strategies on short- or long-term
mobility outcomes as compared with conventional interventions.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS