Élida Rayanne Viana Pinheiro Galvão

Effects of treadmill inclination on hemiparetic gait: controlled and randomized clinical trial.

ObjectiveThe aim of this study was to analyze the effects of inclined treadmill training on the kinematic characteristics of gait in subjects with hemiparesis. DesignA blind, randomized, controlled study was conducted with 28 subjects divided into two groups: the control group, submitted to partial body weight–support treadmill gait training with no inclination, and the experimental group, which underwent partial body weight–support treadmill training at 10% of inclination. All volunteers were assessed for functional independence, motor function, balance, and gait before and after the 12 training sessions. ResultsBoth groups showed posttraining alterations in balance (P < 0.001), motor function (P < 0.001), and functional independence (P = 0.002). Intergroup differences in spatiotemporal differences were observed, where only the experimental group showed posttraining alterations in velocity (P = 0.02) and paretic step length (P = 0.03). Angular variables showed no significant differences in either group. ConclusionsIn subjects with hemiparesis, the addition of inclination is a stimulus capable of enhancing the effects of partial body weight–support treadmill gait training.

Knowledge translation in pediatric rehabilitation: expanding access to scientific knowledge

a Universidade Federal do Rio Grande do Norte (UFRN), Trairi Health Sciences Faculty, Physical Therapy Course, Santa Cruz, RN, Brazil b Universidade Federal do Rio Grande do Norte (UFRN), Trairi Health Sciences Faculty, Rehabilitation Sciences Program, Santa Cruz, RN, Brazil c Universidade Federal do Rio Grande do Norte (UFRN), Trairi Health Sciences Faculty, Public Health Program, Santa Cruz, RN, Brazil d Universidad Federal do Rio Grande do Norte (UFRN), Physical Therapy Master’s and Doctoral Programs, Physical Therapy Course, Natal, RN, Brazil e McGill University, School of Physical and Occupational Therapy, Occupational Therapy Program, Montreal, Canada

Efeitos da adição de carga na marcha de crianças com paralisia cerebral: relato de três casos

Our purpose in this study was to analyze the immediate effects of locomotor gait training with different loads on a treadmill on the kinematic parameters of gait in children with Spastic Hemiparetic Cerebral Palsy (SHCP), as well as investigating which load prompted the most adequate motor responses to promote the propulsion of the Paretic Lower Limb (PLL). This case report included 3 children of both sexes, aged 8-12 years. The children walked on the treadmill with loads on their ankles that corresponded to 40, 50 and 60% of the weight of the Lower Limb (LL), on 3 different non-consecutive days. The kinematic parameters were assessed during the pre-training phase (PTPH) and immediately after training (PHI). The spatiotemporal variables did not change immediately after gait training with the aforementioned loads. On the other hand, we observed wider joint angles in the hip and knee during the swing phase immediately after training, especially with a load of 60% of the weight of the lower limb. These findings indicate that the 60% load is the most appropriate to prompt immediate changes in the joint kinematics of the PLL. These alterations can be important in improving propulsion during the swing phase of gait in children with SHCP.O objetivo deste estudo foi analisar os efeitos imediatos do treino locomotor na esteira com diferentes cargas, sobre os parâmetros cinematicos da marcha de criancas com Paralisia Cerebral Hemiparetica Espastica (PCHE), e investigar qual carga promove repostas motoras mais adequadas para favorecer a propulsao do Membro Inferior Paretico (MIP). Participaram deste relato de caso 3 criancas de ambos os sexos, com idades de 8-12 anos. As criancas realizaram treino na esteira com carga nos tornozelos equivalentes a 40, 50 e 60% do peso do Membro Inferior (MI), em 3 dias diferentes e nao consecutivos. Os parâmetros cinematicos foram avaliados nas fases pre-treinamento (FPT) e imediatamente apos o treino (FI). As variaveis espaco-temporais nao sofreram alteracoes imediatamente apos o treino de marcha com carga. Por outro lado, foi observado aumento dos ângulos articulares de quadril e joelho durante a fase de balanco imediatamente apos o treino, principalmente com carga de 60% do peso do membro inferior. Estes achados indicam que a carga de 60% seja a mais apropriada para solicitar alteracoes imediatas na cinematica articular do MIP. Tais alteracoes podem ser importantes para favorecer a propulsao durante a fase de balanco da marcha de criancas com PCHE.

Effects of adding load to the gait of children with cerebral palsy: a three-case report

Our purpose in this study was to analyze the immediate effects of locomotor gait training with different loads on a treadmill on the kinematic parameters of gait in children with Spastic Hemiparetic Cerebral Palsy (SHCP), as well as investigating which load prompted the most adequate motor responses to promote the propulsion of the Paretic Lower Limb (PLL). This case report included 3 children of both sexes, aged 8-12 years. The children walked on the treadmill with loads on their ankles that corresponded to 40, 50 and 60% of the weight of the Lower Limb (LL), on 3 different non-consecutive days. The kinematic parameters were assessed during the pre-training phase (PTPH) and immediately after training (PHI). The spatiotemporal variables did not change immediately after gait training with the aforementioned loads. On the other hand, we observed wider joint angles in the hip and knee during the swing phase immediately after training, especially with a load of 60% of the weight of the lower limb. These findings indicate that the 60% load is the most appropriate to prompt immediate changes in the joint kinematics of the PLL. These alterations can be important in improving propulsion during the swing phase of gait in children with SHCP.O objetivo deste estudo foi analisar os efeitos imediatos do treino locomotor na esteira com diferentes cargas, sobre os parâmetros cinematicos da marcha de criancas com Paralisia Cerebral Hemiparetica Espastica (PCHE), e investigar qual carga promove repostas motoras mais adequadas para favorecer a propulsao do Membro Inferior Paretico (MIP). Participaram deste relato de caso 3 criancas de ambos os sexos, com idades de 8-12 anos. As criancas realizaram treino na esteira com carga nos tornozelos equivalentes a 40, 50 e 60% do peso do Membro Inferior (MI), em 3 dias diferentes e nao consecutivos. Os parâmetros cinematicos foram avaliados nas fases pre-treinamento (FPT) e imediatamente apos o treino (FI). As variaveis espaco-temporais nao sofreram alteracoes imediatamente apos o treino de marcha com carga. Por outro lado, foi observado aumento dos ângulos articulares de quadril e joelho durante a fase de balanco imediatamente apos o treino, principalmente com carga de 60% do peso do membro inferior. Estes achados indicam que a carga de 60% seja a mais apropriada para solicitar alteracoes imediatas na cinematica articular do MIP. Tais alteracoes podem ser importantes para favorecer a propulsao durante a fase de balanco da marcha de criancas com PCHE.

Post-stroke hemiparesis: Does chronicity, etiology, and lesion side are associated with gait pattern?

Abstract Background: Studies that evaluate gait rehabilitation programs for individuals with stroke often consider time since stroke of more than six months. In addition, most of these studies do not use lesion etiology or affected cerebral hemisphere as study factors. However, it is unknown whether these factors are associated with post-stroke motor performance after the spontaneous recovery period. Objective: To investigate whether time since stroke onset, etiology, and lesion side is associated with spatiotemporal and angular gait parameters of individuals with chronic stroke. Methods: Fifty individuals with chronic hemiparesis (20 women) were evaluated. The sample was stratified according to time since stroke (between 6 and 12 months, between 13 and 36 months, and over 36 months), affected cerebral hemisphere (left or right) and lesion etiology (ischemic and hemorrhagic). The participants were evaluated during overground walking at self-selected gait speed, and spatiotemporal and angular gait parameters were calculated. Results Differences between gait speed, stride length, hip flexion, and knee flexion were observed in subgroups stratified based on lesion etiology. Survivors of a hemorrhagic stroke exhibited more severe gait impairment. Subgroups stratified based on time since stroke only showed intergroup differences for stride length, and subgroups stratified based on affected cerebral hemisphere displayed between-group differences for swing time symmetry ratio. Conclusion: In order to recruit a more homogeneous sample, more accurate results were obtained and an appropriate rehabilitation program was offered, researchers and clinicians should consider that gait pattern might be associated with time since stroke, affected cerebral hemisphere and lesion etiology.

Efectos de la adición de carga sobre la marcha de niños con parálisis cerebral: relato de tres casos

Our purpose in this study was to analyze the immediate effects of locomotor gait training with different loads on a treadmill on the kinematic parameters of gait in children with Spastic Hemiparetic Cerebral Palsy (SHCP), as well as investigating which load prompted the most adequate motor responses to promote the propulsion of the Paretic Lower Limb (PLL). This case report included 3 children of both sexes, aged 8-12 years. The children walked on the treadmill with loads on their ankles that corresponded to 40, 50 and 60% of the weight of the Lower Limb (LL), on 3 different non-consecutive days. The kinematic parameters were assessed during the pre-training phase (PTPH) and immediately after training (PHI). The spatiotemporal variables did not change immediately after gait training with the aforementioned loads. On the other hand, we observed wider joint angles in the hip and knee during the swing phase immediately after training, especially with a load of 60% of the weight of the lower limb. These findings indicate that the 60% load is the most appropriate to prompt immediate changes in the joint kinematics of the PLL. These alterations can be important in improving propulsion during the swing phase of gait in children with SHCP.O objetivo deste estudo foi analisar os efeitos imediatos do treino locomotor na esteira com diferentes cargas, sobre os parâmetros cinematicos da marcha de criancas com Paralisia Cerebral Hemiparetica Espastica (PCHE), e investigar qual carga promove repostas motoras mais adequadas para favorecer a propulsao do Membro Inferior Paretico (MIP). Participaram deste relato de caso 3 criancas de ambos os sexos, com idades de 8-12 anos. As criancas realizaram treino na esteira com carga nos tornozelos equivalentes a 40, 50 e 60% do peso do Membro Inferior (MI), em 3 dias diferentes e nao consecutivos. Os parâmetros cinematicos foram avaliados nas fases pre-treinamento (FPT) e imediatamente apos o treino (FI). As variaveis espaco-temporais nao sofreram alteracoes imediatamente apos o treino de marcha com carga. Por outro lado, foi observado aumento dos ângulos articulares de quadril e joelho durante a fase de balanco imediatamente apos o treino, principalmente com carga de 60% do peso do membro inferior. Estes achados indicam que a carga de 60% seja a mais apropriada para solicitar alteracoes imediatas na cinematica articular do MIP. Tais alteracoes podem ser importantes para favorecer a propulsao durante a fase de balanco da marcha de criancas com PCHE.