Is lateral external perturbation training more beneficial for protective stepping responses than voluntary stepping training in stroke? A pilot randomized control study

Abstract The study examined whether lateral perturbation training could improve stepping performance and balance in individuals post-stroke. Thirty-one participants with hemiparesis were randomly allocated to PERT (external perturbation) or VOL (voluntary stepping) step training. The PERT and VOL gr...

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Main Authors: Marcel B. Lanza, Masahiro Fujimoto, Larry Magder, Sandy McCombe-Waller, Mark W. Rogers, Vicki L. Gray
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Journal of NeuroEngineering and Rehabilitation
Subjects:
Online Access:https://doi.org/10.1186/s12984-024-01495-7
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author Marcel B. Lanza
Masahiro Fujimoto
Larry Magder
Sandy McCombe-Waller
Mark W. Rogers
Vicki L. Gray
author_facet Marcel B. Lanza
Masahiro Fujimoto
Larry Magder
Sandy McCombe-Waller
Mark W. Rogers
Vicki L. Gray
author_sort Marcel B. Lanza
collection DOAJ
description Abstract The study examined whether lateral perturbation training could improve stepping performance and balance in individuals post-stroke. Thirty-one participants with hemiparesis were randomly allocated to PERT (external perturbation) or VOL (voluntary stepping) step training. The PERT and VOL group consisted of 80 step trials predominantly in the lateral direction, with a small proportion of steps in the anterior/posterior direction. Outcome measures based on step type (medial and lateral) included step initiation time, step length, step clearance, step velocity during an induced waist pull perturbation and voluntary step, and clinical balance assessments. The PERT group initiated a lateral step faster with the non-paretic leg during the induced waist pull perturbation step (P = 0.044) than the VOL group after training. Both groups improved the non-paretic step length and step velocity during lateral steps. During the voluntary steps, the PERT group significantly initiated a voluntary step faster. No significant changes were observed in the paretic leg. Both groups significantly improved on the Community Balance & Mobility Scale and Activities Specific Balance Confidence Scale. Overall, we demonstrated that an exercise to improve stepping performance with external perturbations might provide more benefits in protective stepping responses than training with voluntary steps for individuals with a stroke.
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spelling doaj-art-2573adf302e74c26a847d797a65b087a2024-11-17T12:13:36ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032024-11-0121111010.1186/s12984-024-01495-7Is lateral external perturbation training more beneficial for protective stepping responses than voluntary stepping training in stroke? A pilot randomized control studyMarcel B. Lanza0Masahiro Fujimoto1Larry Magder2Sandy McCombe-Waller3Mark W. Rogers4Vicki L. Gray5Department of Physical Therapy and Rehabilitation Science, University of Maryland School of MedicineHealth and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST)Department of Epidemiology and Public Health, University of Maryland School of MedicineDepartment of Physical Therapy and Rehabilitation Science, University of Maryland School of MedicineDepartment of Physical Therapy and Rehabilitation Science, University of Maryland School of MedicineDepartment of Physical Therapy and Rehabilitation Science, University of Maryland School of MedicineAbstract The study examined whether lateral perturbation training could improve stepping performance and balance in individuals post-stroke. Thirty-one participants with hemiparesis were randomly allocated to PERT (external perturbation) or VOL (voluntary stepping) step training. The PERT and VOL group consisted of 80 step trials predominantly in the lateral direction, with a small proportion of steps in the anterior/posterior direction. Outcome measures based on step type (medial and lateral) included step initiation time, step length, step clearance, step velocity during an induced waist pull perturbation and voluntary step, and clinical balance assessments. The PERT group initiated a lateral step faster with the non-paretic leg during the induced waist pull perturbation step (P = 0.044) than the VOL group after training. Both groups improved the non-paretic step length and step velocity during lateral steps. During the voluntary steps, the PERT group significantly initiated a voluntary step faster. No significant changes were observed in the paretic leg. Both groups significantly improved on the Community Balance & Mobility Scale and Activities Specific Balance Confidence Scale. Overall, we demonstrated that an exercise to improve stepping performance with external perturbations might provide more benefits in protective stepping responses than training with voluntary steps for individuals with a stroke.https://doi.org/10.1186/s12984-024-01495-7FallsHemiparesisExerciseInduced stepVoluntary step
spellingShingle Marcel B. Lanza
Masahiro Fujimoto
Larry Magder
Sandy McCombe-Waller
Mark W. Rogers
Vicki L. Gray
Is lateral external perturbation training more beneficial for protective stepping responses than voluntary stepping training in stroke? A pilot randomized control study
Journal of NeuroEngineering and Rehabilitation
Falls
Hemiparesis
Exercise
Induced step
Voluntary step
title Is lateral external perturbation training more beneficial for protective stepping responses than voluntary stepping training in stroke? A pilot randomized control study
title_full Is lateral external perturbation training more beneficial for protective stepping responses than voluntary stepping training in stroke? A pilot randomized control study
title_fullStr Is lateral external perturbation training more beneficial for protective stepping responses than voluntary stepping training in stroke? A pilot randomized control study
title_full_unstemmed Is lateral external perturbation training more beneficial for protective stepping responses than voluntary stepping training in stroke? A pilot randomized control study
title_short Is lateral external perturbation training more beneficial for protective stepping responses than voluntary stepping training in stroke? A pilot randomized control study
title_sort is lateral external perturbation training more beneficial for protective stepping responses than voluntary stepping training in stroke a pilot randomized control study
topic Falls
Hemiparesis
Exercise
Induced step
Voluntary step
url https://doi.org/10.1186/s12984-024-01495-7
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