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Cardiac Output II: Effect of Stroke Volume on Cardiac Output01:22

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A Rehabilitation Program of Exoskeleton-assisted Body Weight-Supported Treadmill Training with Non-immersive Virtual Reality for Stroke Patients
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Walking speed changes in response to user-driven treadmill control after stroke.

Nicole T Ray1, Darcy S Reisman2, Jill S Higginson3

  • 1Mechanical Engineering, University of Delaware, Newark, DE, USA.

Journal of Biomechanics
|January 28, 2020
PubMed
Summary
This summary is machine-generated.

Individuals post-stroke can achieve faster walking speeds using user-driven treadmill (UDTM) control without increasing push-off forces. This suggests adaptive postural adjustments enhance propulsion efficiency in gait rehabilitation.

Keywords:
StrokeTreadmill-based gait trainingUser-driven treadmill control

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Area of Science:

  • Biomechanics
  • Rehabilitation Engineering
  • Neurorehabilitation

Background:

  • Gait impairments are common after stroke, significantly impacting mobility and independence.
  • Treadmill training is a common rehabilitation strategy, but traditional fixed-speed models may not optimize individual recovery.
  • User-driven treadmill (UDTM) control offers a potentially more adaptive approach to gait training.

Purpose of the Study:

  • To investigate post-stroke responses to UDTM control versus fixed-speed treadmill (FSTM) control.
  • To analyze changes in walking speed, ground reaction forces, and limb kinematics.
  • To understand the biomechanical adaptations enabling faster speeds with UDTM.

Main Methods:

  • Twenty individuals with chronic stroke participated.
  • Walking parameters were assessed during overground and treadmill walking (FSTM and UDTM).
  • Key metrics included self-selected (SS) and fastest comfortable (Fast) walking speeds, peak anterior/posterior ground reaction forces (AGRF/PGRF), and trailing limb angles (TLA).
  • Paired t-tests analyzed differences between conditions.

Main Results:

  • Participants achieved faster comfortable walking speeds with UDTM compared to FSTM (p < 0.05).
  • No significant differences in peak AGRF or PGRF were observed between UDTM and FSTM conditions.
  • Increased paretic trailing limb angle (TLA) was noted at SS speeds with UDTM (p < 0.05).
  • Forward propulsion demands remained similar across conditions, despite faster speeds with UDTM.

Conclusions:

  • UDTM control facilitates faster walking speeds post-stroke without requiring greater propulsive forces.
  • Individuals likely adopt altered postural strategies to optimize forward propulsion efficiency with UDTM.
  • This suggests UDTM control holds promise for enhancing gait rehabilitation by enabling faster, more efficient walking.
  • Further research is needed to optimize UDTM prescription for clinical gait training programs.