ABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the effect of treadmill training with body weight support on gait kinematics parameters in patients with PD using DBS. DESIGN: Twelve patients completed the protocols (age: 60.9±10.6 years; disease duration: 20±7 years; and time since DBS surgery: 20±4 months). The same set of patients underwent two trainings protocols and four gait analyses (before and after each training). They received eight weeks of treadmill training without body weight support (16 sessions) in conjunction with physiotherapy program followed by six weeks of wash out period, followed by eight weeks of body-weight-supported treadmill training in conjunction with a same physiotherapy program. The Gait Kinematic Analysis involved eight infrared cameras that detected 19 reflective spherical markers attached in limb lower of patients. Statistical analysis used the Wilcoxon test (p≤0.05). RESULTS: Both the training no showed significant differences in linear variables. As the angular variables, only training with support showed significant increase of ranges of motion: pelvis tilt, obliquity and rotation amplitude; hip adduction-abduction and rotation amplitude; percentage of peak flexion in swing phase; foot progression amplitude. CONCLUSION: The body weight supported treadmill training may promote increase of mobility of lower limbs during gait and it could be a targeted intervention for PD patients treated with DBS.
Subject(s)
Deep Brain Stimulation/methods , Exercise Therapy/methods , Gait , Parkinson Disease/therapy , Aged , Biomechanical Phenomena , Female , Humans , Male , Middle Aged , Parkinson Disease/rehabilitationABSTRACT
For evaluating the patterns of brain activation in sensorimotor areas following motor rehabilitation, seven male patients diagnosed with TBI underwent an fMRI study before and after being subjected to motor rehabilitation. Six patients showed a reduction in the BOLD signal of their motor cortical areas during the second fMRI evaluation. A decrease in cerebellum activation was also observed in two patients. Newly activated areas, were observed in four patients after treatment. In addition, an increase in the activation of the supplementary motor area (SMA) following rehabilitation was observed in only one test subject. The findings show that motor rehabilitation in TBI patients produces a decrease in the BOLD signal for the sensorimotor areas that were activated prior to treatment. In addition, we observed the recruitment of different brain areas to compensate for functional loss due to TBI in line with the cortical reorganisation mechanism.
Subject(s)
Brain Injuries/pathology , Brain Injuries/rehabilitation , Motor Cortex/pathology , Somatosensory Cortex/pathology , Adult , Body Weight , Cerebellum/physiology , Data Interpretation, Statistical , Gait/physiology , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Male , Oxygen/blood , Physical Education and Training , Recruitment, Neurophysiological , Young AdultABSTRACT
INTRODUCTION: Over recent years it has become possible to retrain motor activity among patients with partial spinal cord injury, especially for walking. AIM. To assess the impact of gait training on a treadmill with body weight support, regarding temporospatial parameters and quality of life. PATIENTS AND METHODS: Twelve patients of both sexes were evaluated. They had been diagnosed with partial spinal cord injury of traumatic origin at least 12 months earlier. They were able to walk and their motor function below the level of the injury was partially preserved and classified as level C or D. After the initial evaluation, the participants were trained on a treadmill with body weight support, with two sessions per week lasting 30 minutes each, over a four-month period, thus totaling 30 sessions. The patients' temporospatial gait parameters and quality of life were analyzed before and after the training. RESULTS: There were improvements in all the temporospatial parameters evaluated (p < 0.0001), but no changes in quality of life were seen (p > 0.05). CONCLUSION: Treadmill training with body weight support among patients with spinal cord injury was effective in improving the temporospatial gait parameters, but without changing their quality of life.
Subject(s)
Gait , Quality of Life , Spinal Cord Injuries/physiopathology , Spinal Cord Injuries/rehabilitation , Female , Humans , MaleABSTRACT
Durante los últimos años ha sido posible rehabilitar la actividad motora en los pacientes con lesiónmedular parcial, especialmente para poder caminar. Objetivo. Evaluar el impacto del entrenamiento de la marcha en una cinta sin fin con soporte del peso corporal con respecto a los parámetros temporoespaciales y la calidad de vida. Pacientes y métodos.Se estudió a 12 pacientes de ambos sexos. Se les había diagnosticado una lesión medular parcial de origen traumático al menos 12 meses antes. Podían caminar, y su función motora por debajo del nivel de la lesión estaba parcialmente preservada y clasificada como nivel C o D. Después de la evaluación inicial, los participantes se entrenaron en una cinta sin fin consoporte del peso corporal, con dos sesiones por semana de 30 minutos de duración cada una, durante un período de cuatro meses, lo que supuso un total de 30 sesiones. Los parámetros temporoespaciales de la marcha y la calidad de vida de los pacientesse analizaron antes y después del entrenamiento. Resultados. Hubo mejoras importantes en todos los parámetros temporoespaciales evaluados (p < 0,0001), pero no se observaron cambios en la calidad de vida (p > 0,05). Conclusión. El entrenamiento en una cinta sin fin con soporte del peso corporal en pacientes con lesión medular fue eficaz a la hora de mejorar los parámetros temporoespaciales de la marcha, pero no se produjeron cambios en su calidad de vida
Over recent years it has become possible to retrain motor activity among patients with partial spinalcord injury, especially for walking. Aim. To assess the impact of gait training on a treadmill with body weight support, regarding temporospatial parameters and quality of life. Patients and methods. Twelve patients of both sexes were evaluated. They had been diagnosed with partial spinal cord injury of traumatic origin at least 12 months earlier. They were able to walkand their motor function below the level of the injury was partially preserved and classified as level C or D. After the initial evaluation, the participants were trained on a treadmill with body weight support, with two sessions per week lasting 30minutes each, over a four-month period, thus totaling 30 sessions. The patients temporospatial gait parameters and quality of life were analyzed before and after the training. Results. There were improvements in all the temporospatial parameters evaluated (p < 0.0001), but no changes in quality of life were seen (p > 0.05). Conclusion. Treadmill training with body weightsupport among patients with spinal cord injury was effective in improving the temporospatial gait parameters, but without changing their quality of life
