Awosika Oluwole O, Chan Dorothy, Rizik Bridget A, Sucharew Heidi J, Boyne Pierce, Bhattacharya Amit, Dunning Kari, Kissela Brett M
Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, United States.
Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Front Neurol. 2022 Mar 14;13:800757. doi: 10.3389/fneur.2022.800757. eCollection 2022.
Walking impairment remains a major limitation to functional independence after stroke. Yet, comprehensive and effective strategies to improve walking function after stroke are presently limited. Backward Locomotor Treadmill Training (BLTT) is a promising training approach for improving walking function; however, little is known about its mechanism of effect or the relationship between backward walking training and resulting overground forward walking performance. This study aims to determine the effects of serial BLTT on spatial aspects of backward and forward walking in chronic post-stroke individuals with residual walking impairment.
Thirty-nine adults (>6 months post-stroke) underwent 6 days of BLTT (3 × /week) over 2 weeks. Outcome measures included PRE-POST changes in backward and forward walking speeds, paretic and non-paretic step lengths, and single-support center of pressure distances. To determine the association between BLTT and overground walking, correlation analyses comparing training-related changes in these variables were performed.
We report an overall improvement in BLTT and overground walking speeds, bilateral step lengths, and single-support center of pressure distances over six training sessions. Further, there were weak positive associations between PRE-POST changes in BLTT speed, BLTT paretic step length, and overground forward walking speed.
Our findings suggest that individuals with chronic post-stroke walking impairment experience improvements in spatial walking measures during BLTT and overground. Therefore, BLTT may be a potential adjunctive training approach for post-stroke walking rehabilitation.
步行障碍仍然是中风后功能独立的主要限制因素。然而，目前改善中风后步行功能的全面且有效策略有限。反向运动跑步机训练（BLTT）是一种有前景的改善步行功能的训练方法；然而，对于其作用机制或反向步行训练与随后的地面向前步行表现之间的关系知之甚少。本研究旨在确定连续BLTT对慢性中风后有步行障碍残留个体的反向和向前步行空间参数的影响。
39名成年人（中风后超过6个月）在2周内接受了6天的BLTT训练（每周3次）。结果测量包括反向和向前步行速度、患侧和非患侧步长以及单支撑压力中心距离的训练前后变化。为了确定BLTT与地面步行之间的关联，对这些变量中与训练相关的变化进行了相关性分析。
我们报告在六个训练疗程中，BLTT和地面步行速度、双侧步长以及单支撑压力中心距离总体上有所改善。此外，BLTT速度、BLTT患侧步长的训练前后变化与地面向前步行速度之间存在弱正相关。
我们的研究结果表明，慢性中风后步行障碍个体在BLTT训练期间和地面步行时，其空间步行参数有所改善。因此，BLTT可能是中风后步行康复的一种潜在辅助训练方法。
