Article

Robot-assisted locomotor training on a
bodyweight-supported treadmill is a rehabilitation intervention that compels
repetitive practice of gait movements. Standard treadmill speed may elicit
rhythmic movements generated primarily by spinal circuits. Slower-than-standard
treadmill speed may elicit discrete movements, which are more complex than
rhythmic movements and involve cortical areas. OBJECTIVE: Compare effects of fast
(i.e., rhythmic) versus slow
(i.e., discrete) robot-assisted locomotor training
on a bodyweight-supported treadmill in subjects with chronic, severe gait deficit
after stroke. METHODS: Subjects (N = 18) were randomized to receive 30 sessions
(5 d/wk) of either fast or slow robot-assisted locomotor training on a
bodyweight-supported treadmill in an inpatient setting. Functional ambulation
category, time up and go, 6-min walk test, 10-m walk test, Berg Balance Scale,
and Fugl-Meyer Assessment were administered at baseline and postintervention.
RESULTS: The slow group had statistically significant improvement on functional
ambulation category (first quartile-third quartile, P = 0.004), 6-min walk test
(95% confidence interval [CI] = 1.8 to 49.0, P = 0.040), Berg Balance Scale (95%
CI = 7.4 to 14.8, P < 0.0001), time up and go (95% CI = -79.1 to 5.0, P <
0.0030), and Fugl-Meyer Assessment (95% CI = 24.1 to 45.1, P < 0.0001). The fast
group had statistically significant improvement on Berg Balance Scale (95% CI =
1.5 to 10.5, P = 0.02). CONCLUSIONS: In initial stages of robot-assisted
locomotor training on a bodyweight-supported treadmill after severe stroke, slow
training targeting discrete movement may yield greater benefit than fast training.

Langue : ANGLAIS