Department and Clinic for Rehabilitation and Physiotherapy, University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland.
Int J Environ Res Public Health. 2022 Dec 16;19(24):16925. doi: 10.3390/ijerph192416925.
Functional limitations after a stroke are unique to each person and often include impaired independent mobility. A reduction in existing gait deficits after a stroke is often one of the main goals of rehabilitation. Gait re-education after stroke is a complex process, which consists of the effects of many therapeutic interventions.
The study aimed to analyze the effects of using a treadmill with visual feedback in gait re-education in the sub-acute stroke period and assess the impact of biofeedback treadmill training on selected gait parameters, improving static balance and reducing the need for orthopedic aids.
The study included 92 patients (F: 45, M: 47) aged 63 ± 12 years, with post-ischemic sub-acute (within six months onset) stroke hemiparesis, treated at a neurological rehabilitation ward. All patients participated in a specific rehabilitation program, and in addition, patients in the study group ( = 62) have a further 10 min of treadmill training with visual feedback. Patients in the control group ( = 30) participated in additional conventional gait training under the direct supervision of a physiotherapist. The evaluation of static balance was assessed with the Romberg Test. A Biodex Gait Trainer 3 treadmill with biofeedback function was used to evaluate selected gait parameters (walking speed, step length, % limb loading, and traveled distance). The use of an orthopedic aid (walker or a crutch) was noted.
After four weeks of rehabilitation, step length, walking speed, traveled distance, and static balance were significantly improved for the study and control group ( < 0.05). Treadmill gait training yielded significantly better results than a conventional rehabilitation program. Only the study group observed a corrected walking base ( < 0.001). All participants showed a reduction in the use of walking aids ( = 0.006). There was no asymmetry in the % of limb loading for either group prior to or following rehabilitation.
The treadmill with visual biofeedback as conventional gait training has resulted in a significant improvement in parameters such as step length, walking speed, static balance, and a reduction in the use of locomotion aids. However, the achieved improvement in gait parameters is still not in line with the physiological norm.
中风后的功能障碍因人而异，通常包括独立移动能力受损。中风后减少现有的步态缺陷通常是康复的主要目标之一。中风后的步态再教育是一个复杂的过程，它包含了许多治疗干预的效果。
本研究旨在分析在亚急性中风期使用带视觉反馈的跑步机进行步态再教育的效果，并评估生物反馈跑步机训练对选定步态参数的影响，改善静态平衡并减少对矫形辅助工具的需求。
该研究纳入了 92 名年龄为 63 ± 12 岁的患者（女性 45 名，男性 47 名），均为缺血性亚急性（发病后 6 个月内）中风偏瘫患者，在神经康复病房接受治疗。所有患者均参加了特定的康复计划，此外，研究组（n=62）的患者还接受了 10 分钟带视觉反馈的跑步机训练。对照组（n=30）的患者在物理治疗师的直接监督下进行额外的常规步态训练。静态平衡的评估采用 Romberg 测试。使用带生物反馈功能的 Biodex Gait Trainer 3 跑步机评估选定的步态参数（步行速度、步长、肢体负重百分比和行走距离）。记录矫形辅助工具（助行器或拐杖）的使用情况。
经过四周的康复治疗，研究组和对照组的步长、步行速度、行走距离和静态平衡均显著改善（p＜0.05）。跑步机步态训练的效果明显优于常规康复方案。只有研究组观察到行走基底得到了纠正（p＜0.001）。所有参与者均减少了对助行器的使用（p=0.006）。在康复前后，两组的肢体负重百分比均无明显的不对称性。
带视觉生物反馈的跑步机作为常规步态训练，可显著改善步长、步行速度、静态平衡和减少对助行工具的使用等参数。然而，步态参数的改善仍未达到生理标准。
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