Duration and intensity of walking activities and gait training in stroke patients and healthy subjects.

Pijpers, E.J. (2010) Duration and intensity of walking activities and gait training in stroke patients and healthy subjects. thesis, Human Movement Sciences.

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Abstract

Objectives The first main objective was to 1) determine the amount of time stroke patients walk during the rehabilitation period, 2) determine the intensity of walking activity in general and during gait training in particular, and 3) relate both amount and intensity of walking to functional ability and quality of life. The second main objective was to determine the intensity of robot-assisted gait training compared to treadmill walking in healthy subjects and investigate how this is influenced by the amount of body weight support (BWS), guidance force (GF) of the lower limbs and walking speed. Design Descriptive and correlational for the study in stroke patients; repeated within-subjects comparison for healthy subjects. Setting Rehabilitation center and research lab. Participants Seventeen patients with hemiparesis after stroke and ten healthy subjects. Main outcome measures Walking activity (duration and bouts), intensity of walking (% heart rate reserve; HRR, rate of perceived exertion; RPE, oxygen consumption; V02 , oxygen cost, physiological cost index; PCI), functional ability (10 meter walk test, Timed-up-and-go test, Berg balance scale, Rivermead mobility index) and quality of life (Short-form 36). Results High and significant correlations were found between duration of walking and functional ability (r=0.59-0.91, p<0.05), but not between intensity of walking, functional ability and quality of life. Also, quality of life and walking activity show no high correlations. Walking in the Lokomat with higher speed resulted in lower oxygen cost {p<0.05) but did not influence V02, %HRR or PCI. Furthermore, walking in the Lokomat with little guidance and support resulted in the highest V02, %HRR, oxygen cost and PCI (p<0.05). Interestingly, walking in the Lokomat with much guidance and support was not statistically different from treadmill walking, suggesting that even with much guidance and support Lokomat walking is equally intense as treadmill walking. Conclusions Patients with low functional ability walk little during daily life during the rehabilitation period, and therefore receive little practice. Intensity of robot-assisted gait training is not lower than of treadmill walking and may be even increased with reducing the BWS and GF. As one of the advantages of robot-assisted gait training is the extended training duration, robot-assisted gait training might be especially valuable for patients with low functional ability in order to achieve more time at appropriate training intensity.

Item Type:	Thesis (Thesis)
Supervisor name:	Woude, Prof. Dr. L.H.V. van der
Supervisor name:	Nunen, Drs. M. van and Gerrits, Dr. H.L. and Faculty of Human Movement Sciences, VU University Amsterdam and Duyvensz-Nagel Onderzoekslaboratorium, Rehabilitation Center
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:48
Last Modified:	25 Jun 2020 10:48
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/921

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