Body weight supported treadmill vs. overground gait training for acute stroke gait rehabilitation.

The purpose of this study was to evaluate the clinical efficacy of body weight supported treadmill training for acute post-stroke rehabilitation, relative to conventional therapy. Forty individuals were randomized to receive either body weight supported treadmill training or conventional therapy as part of standard care at an acute rehabilitation facility. As part of normal care patients were evaluated using the Functional Independence Measure; gait units and length of stay were also recorded. Within 48 hours of discharge, participants were evaluated using a Qualisys motion capture system to measure spatiotemporal gait parameters. Participants allocated to the body weight supported treadmill training group had a significantly lower admission Functional Independence Measure, but had a longer length of stay, and did not have significantly different discharge Functional Independence Measure scores. Gait speed was the only spatiotemporal outcome that was significantly different at discharge, and was lower for the body weight supported treadmill training group. As seen in previous literature, the clinical efficacy of body weight supported treadmill training seems to be similar to that of conventional overground therapy. Accounting for difference in admission scores the body weight supported treadmill training and conventional therapy groups, both methods performed comparably.

Kinetic asymmetry in transfemoral amputees while performing sit to stand and stand to sit movements.

Transitional movements are a determinant of functional independence and have limited study in amputees. Microprocessor prosthetic knees' abilities to assist transfemoral amputees with sitting and standing have not been studied. Through cross-sectional study, 21 transfemoral amputees, divided into 3 groups of 7 by knee type (power knee, C-leg, Mauch SNS) and 7 non-amputee controls (n=28) performed sit to stand and stand to sit while kinematic and kinetic data were recorded. Transfemoral amputees can stand (1.6-2.0s) and sit (2.1-2.8s) at rates comparable to controls (1.6s). Controls' ground reaction force (GRF) and knee moment production was <7% asymmetric and superior to amputees' during both movements. For sit to stand, amputees' asymmetry for GRF ranged from 53 to 69% and 110 to 124% for knee moments. For stand to sit, amputees' asymmetry for GRF ranged from 32 to 60% and 84 to 114% for knee moments. Hip moment asymmetry for sit to stand was less for control (21%) and power knee (34%) groups than that produced by the Mauch SNS (59%) group. For stand to sit, hip moment production for the Mauch SNS (47%) and C-leg groups (71%) were more asymmetric than controls (19%). In the majority of cases transfemoral amputees do not load their prosthesis extensively for standing up or sitting down. Therefore, this transitional movement is currently a one-legged task, which increases stress on the sound limb. Generally, the prosthetic knees studied did not produce a significant knee moment in either task. Although most differences between knee groups were not statistically significant, differences may be clinically meaningful on an individual basis.