Original articleCoordination of Dynamic Balance During Gait Training in People With Acquired Brain Injury
Section snippets
Participants
Seventeen people (10 men; mean age ± SD, 38.7±15.3y; mean height ± SD, 175.0±8.6cm; mean body mass ± SD, 72.4±22.7kg) with an ABI and who could not walk without assistance were recruited from the rehabilitation units at the Epworth Hospital. Other inclusion criteria were the ability to fully weight bear (for those who had sustained an associated lower-limb fracture) and ability and willingness to provide informed consent. Eleven participants had sustained extremely severe (length of
Results
All participants could complete the THERAPIST, BWSTT+T, BWSTT+UL, and BWSTT+T+UL trials; however, 4, 2, and 2 participants were unable to perform the BWSTT, GAIT AID, and TREADMILL protocols, respectively, due to either physical inability or risk to safety. Five participants were responsible for these 8 incomplete trials, and therefore the data for these participants were excluded from further analysis.
The ML COM displacement amplitude results are provided in figure 2A. A significant main
Discussion
This study examined coordination of the COM during a variety of gait training methods in people with an ABI and compared these results to people with nonpathologic gait. Of the training strategies included in this study, BWSTT with no other support or facilitation performed poorly. It resulted in large COM displacements, poor timing of COM movement within the gait cycle, and reduced stability. These timing and stability results are consistent with the study of Kyvelidou et al,20 who observed
Conclusions
These results indicate that treadmill training (±BWS) with handrail support reduces ML displacement of the COM and postural instability during the gait training session. However, this upper-limb support may come at the cost of altering the timing and variability components of the gait pattern. Careful consideration of these factors should be given when implementing a gait rehabilitation program to achieve adequate postural stability for independent gait; however, further research is required to
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Supported by a grant from the Royal Automobile Club of Victoria.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
In-press corrected proof published online on Feb 13, 2012, at www.archives-pmr.org.