【論文摘要】Effect of Gait Speed Change Training on Chronic Stroke Patients: A Preliminary Study

【論文摘要】步行速度改變訓練於慢性中風病人的成效：初步研究

殷語岑(Yu-Tsen Yin) ； 李佩紜(Pei-Yun Lee) ； 黃貞慈(Jhen-Cih Huang) ； 曾惠瑜(Hui-Yu Tseng) ； 林桑伊(Sang-I Lin)

《物理治療》 46卷2期 (2021/06) Pp. 99-99

https://doi.org/10.6215/FJPT.202106.O06

摘要

Background and Purpose: About 70% stroke survivors experience considerable walking limitation, which could lead to falls, activities limitations, and participation restrictions. Gait speed changing ability is crucial to daily activities, such as crossing a busy intersection and catching a bus. However, there was limited study investigating and training gait speed changing ability in stroke patients. The purpose of this study was to determine the effects of gait speed changing training on walking performance in patients with chronic stroke. Methods: Twenty-six chronic stroke patients were recruited and randomly assigned into the experimental or the control group. Preferred walking speed was measured prior to the training. The experimental group received gait speed changing training, in which they walked on a treadmill at 80%, 90%, 100%, 110%, and 120% of preferred walking speed in random order in one training session. The control group received gait training without speed change. The training was performed 30 minutes/day and 3 days/week for 2 weeks. For assessment, subjects were instructed to walk barefoot on a 6-meter walkway before and after the gait training in two conditions: no-speed change and speed up condition. No-speed change condition included preferred and maximal speed walking. In the speed up condition, subjects were instructed to start walking at preferred speed and speed up to maximal speed when seeing a light cue. Four tasks were randomly tested in the speed up condition: normal speed up (N), speed up with concurrently serial subtraction (SS), speed up on a narrow walkway (Na) and speed up with concurrently serial subtraction on a narrow walkway (NaSS). APDM system (Opals and Mobility Lab) was used to record gait performance. The average speed of the no-speed change condition was recorded. In speed up condition, speed change was calculated as the maximal speed minus the preferred speed in each task. The number of steps taken to speed up and the amount of speed change per step were also calculated. Results: The experimental group took significantly fewer steps to speed up to maximal speed and showed significant increase in the amount of speed change per step in SS than the control group. No group difference was found in the other tasks in the speed up condition. Both groups showed significant improvement in preferred walking speed, and the experimental group also showed significant increase in maximal walking speed. Conclusion: Gait speed changing training on a treadmill could be effective on training the speed changing ability in chronic stroke patients. Patients were able to speed up with fewer steps and had greater amount of speed change per step. The maximal walking speed was also improved after gait speed changing training. Clinical Relevance: Our results provide important information to help design an intervention program for chronic stroke patients to improve their gait speed changing ability.