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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Posterior fall-recovery training applied to individuals with chronic stroke: A single-group intervention study
Clinical biomechanics (Bristol), v 82, 105249
Feb 2021
PMID: 33421756
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To assess the effects of the initial stepping limb on posterior fall recovery in individuals with chronic stroke, as well as to determine the benefits of fall-recovery training on these outcomes.
This was a single-group intervention study of 13 individuals with chronic stroke. Participants performed up to six training sessions, each including progressively challenging, treadmill-induced perturbations from a standing position. Progressions focused on initial steps with the paretic or non-paretic limb. The highest perturbation level achieved, the proportion of successful recoveries, step and trunk kinematics, as well as stance-limb muscle activation about the ankle were compared between the initial stepping limbs in the first session. Limb-specific outcomes were also compared between the first and last training sessions.
In the first session, initial steps with the non-paretic limb were associated with a higher proportion of success and larger perturbations than steps with the paretic limb (p = 0.02, Cohen's d = 0.8). Paretic-limb steps were wider relative to the center of mass (CoM; p = 0.01, d = 1.3), likely due to an initial standing position with the CoM closer to the non-paretic limb (p = 0.01, d = 1.4). In the last training session, participants recovered from a higher proportion of perturbations and advanced to larger perturbations (p < 0.05, d > 0.6). There were no notable changes in kinematic or electromyography variables with training (p > 0.07, d < 0.5).
The skill of posterior stepping in response to a perturbation can be improved with practice in those with chronic stroke, we were not able to identify consistent underlying kinematic mechanisms behind this adaptation.
•Posterior steps with the non-paretic limb were associated with better performance.•Paretic-limb steps were wider relative to the center of mass.•With training, subjects recovered from more perturbations and larger perturbations.•Step and trunk kinematics did not change with training.
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Details
- Title
- Posterior fall-recovery training applied to individuals with chronic stroke: A single-group intervention study
- Creators
- Jamie Pigman - Monmouth UniversityDarcy S. Reisman - University of DelawareRyan T. Pohlig - University of DelawareJohn J. Jeka - University of DelawareTamara R. Wright - University of DelawareBenjamin C. Conner - College of Medicine - Phoenix, University of Arizona, Phoenix, AZ, USADrew A. Petersen - Drexel UniversityMichael S. Christensen - University of DelawareJeremy R. Crenshaw - University of Delaware
- Publication Details
- Clinical biomechanics (Bristol), v 82, 105249
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Physical Therapy (and Rehabilitation Sciences)
- Web of Science ID
- WOS:000632691300014
- Scopus ID
- 2-s2.0-85098946975
- Other Identifier
- 991019168048404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Engineering, Biomedical
- Orthopedics
- Sport Sciences