Gait training of poststroke patients assisted by the Walkaround (body postural support).

Improvement in gait abilities is one of the important goals of stroke rehabilitation. The Walkaround is a new postural assistance device for gait training, which allows an early start for gait training. This device provides body postural support (BPS) and trunk orientation by means of a lumbar belt that is connected to a powered rolling walker. We conducted a randomized, single-blinded, 4-week clinical trial of 22 subacute stroke patients with a follow-up period of 6 months. Patients were divided into two identically sized groups: the treatment group (BPS), which was assisted by the Walkaround, and the control (CON) group, which was assisted by conventional means (cane, therapist) during gait training. The objective of the study was to assess whether the Walkaround is more effective than conventional assistance during gait training. The outcome measures were as follows: Barthel index, Fugl-Meyer score for the lower extremities, Berg balance test, and gait speed. Changes in the outcome measures were significant for the Berg balance score after 6 months in both groups and in gait speed among the BPS group at the end of therapy and after 6 months (P<0.05) compared with the same outcome measures at the beginning of the trial. Significant differences were found in gait speed and Berg balance test scores after 4 weeks and in gait speed after 6 months (P<0.05) between the BPS and the CON groups. The results suggest that added postural support by the Walkaround led to limited yet significant changes in gait speed and balance control.

Low-level laser therapy for acute neck pain with radiculopathy: a double-blind placebo-controlled randomized study.

OBJECTIVE: The objective of the study was to investigate clinical effects of low-level laser therapy (LLLT) in patients with acute neck pain with radiculopathy. DESIGN: Double-blind, randomized, placebo-controlled study. SETTING: The study was carried out between January 2005 and September 2007 at the Clinic for Rehabilitation at the Medical School, University of Belgrade, Serbia. PATIENTS AND INTERVENTION: Sixty subjects received a course of 15 treatments over 3 weeks with active or an inactivated laser as a placebo procedure. LLLT was applied to the skin projection at the anatomical site of the spinal segment involved with the following parameters: wavelength 905 nm, frequency 5,000 Hz, power density of 12 mW/cm(2), and dose of 2 J/cm(2), treatment time 120 seconds, at whole doses 12 J/cm(2). OUTCOME MEASURES: The primary outcome measure was pain intensity as measured by a visual analog scale. Secondary outcome measures were neck movement, neck disability index, and quality of life. Measurements were taken before treatment and at the end of the 3-week treatment period. RESULTS: Statistically significant differences between groups were found for intensity of arm pain (P = 0.003, with high effect size d = 0.92) and for neck extension (P = 0.003 with high effect size d = 0.94). CONCLUSION: LLLT gave more effective short-term relief of arm pain and increased range of neck extension in patients with acute neck pain with radiculopathy in comparison to the placebo procedure.

Acute low back pain with radiculopathy: a double-blind, randomized, placebo-controlled study.

OBJECTIVE: The aim of this study was to investigate the clinical effects of low-level laser therapy (LLLT) in patients with acute low back pain (LBP) with radiculopathy. BACKGROUND DATA: Acute LBP with radiculopathy is associated with pain and disability and the important pathogenic role of inflammation. LLLT has shown significant anti-inflammatory effects in many studies. MATERIALS AND METHODS: A randomized, double-blind, placebo-controlled trial was performed on 546 patients. Group A (182 patients) was treated with nimesulide 200 mg/day and additionally with active LLLT; group B (182 patients) was treated only with nimesulide; and group C (182 patients) was treated with nimesulide and placebo LLLT. LLLT was applied behind the involved spine segment using a stationary skin-contact method. Patients were treated 5 times weekly, for a total of 15 treatments, with the following parameters: wavelength 904 nm; frequency 5000 Hz; 100-mW average diode power; power density of 20 mW/cm(2) and dose of 3 J/cm(2); treatment time 150 sec at whole doses of 12 J/cm(2). The outcomes were pain intensity measured with a visual analog scale (VAS); lumbar movement, with a modified Schober test; pain disability, with Oswestry disability score; and quality of life, with a 12-item short-form health survey questionnaire (SF-12). Subjects were evaluated before and after treatment. Statistical analyses were done with SPSS 11.5. RESULTS: Statistically significant differences were found in all outcomes measured (p < 0.001), but were larger in group A than in B (p < 0.0005) and C (p < 0.0005). The results in group C were better than in group B (p < 0.0005). CONCLUSIONS: The results of this study show better improvement in acute LBP treated with LLLT used as additional therapy.