Search

The article presents a study which describes the effect of a downhill walking training programme for gait ability of chronic stroke survivors. The researchers have conducted a randomized controlled trial to assess the effectiveness of altering the inclination of treadmill training. The findings reveal that downhill treadmill training is more advantageous that uphill training for patients with chronic stroke.

Background. The use of robots for gait training in Parkinson disease (PD) is growing, but no evidence points to an advantage over the standard treadmill. Methods. In this randomized, single-blind controlled trial, participants aged <75 years with early-stage PD (Hoehn-Yahr <3) were randomly allocated to 2 groups: either 30 minutes of gait training on a treadmill or in the Lokomat for 3 d/wk for 4 weeks. Patients were evaluated by a physical therapist blinded to allocation before and at the end of treatment and then at the 3- and 6-month follow-up. The primary outcome measure was the 6-minute walk test. Results. Of 334 screened patients, the authors randomly allocated 30 to receive gait training with treadmill or the Lokomat. At baseline, the 2 groups did not differ. At the 6-month follow-up, both groups had improved significantly in the primary outcome measure (treadmill: mean = 490.95 m, 95% confidence interval [CI] = 448.56-533.34, P = .0006; Lokomat: 458.6 m, 95% CI = 417.23-499.96, P = .01), but no significant differences were found between the 2 groups (P = .53). Discussion. Robotic gait training with the Lokomat is not superior to treadmill training in improving gait performance in patients with PD. Both approaches are safe, with results maintained for up to 6 months. [ABSTRACT FROM PUBLISHER]

Objective: To investigate the effect of different adjunctive treatments after botulinum toxin type A.Design: Single-blind, randomized trial, with three-month follow-up.Setting: Secondary rehabilitative care.Subjects: Convenience sample of 69 chronic hemiplegic adult patients with spastic equinus foot.Interventions: Following botulinum toxin type A injection at the plantar flexors, patients were randomly assigned to three groups and treated with either taping, casting or stretching for one week, and with stretching and gait training for the next week.Outcome measures: Modified Ashworth Scale at plantar flexors, passive range of motion at the ankle, six-minute walking test, 10-metre walking test, Functional Ambulation Categories, ankle dorsiflexor strength were evaluated before treatment (t0) at 20 days (t1) and 90 days (t2) after treatment.Results: At t1 only the taping and casting groups showed significant improvements in Modified Ashworth Scale, six-minute walking test, 10-metre walking test and passive range of motion (P < 0.02). At t2, while the results were maintained in the casting group, only six-minute walking test and Modified Ashworth Scale were still significantly improved in the taping group. Ankle dorsiflexor strength and Functional Ambulation Categories did not change in any of the groups at any time. At t2 the casting group performed better than the taping and stretching groups at Modified Ashworth Scale and passive range of motion, and better than the stretching group at six-minute walking test (P < 0.02).Conclusions: Combining botulinum toxin type A to the ankle plantar flexors with casting or taping gives better and longer lasting results than with stretching alone. [ABSTRACT FROM PUBLISHER]

Objective: To compare results from two approaches used in conjunction with botulinum toxin type A administration in rehabilitation: the application of a taping system and the electrical stimulation of the injected muscles and splinting. Design: Case–control study. Setting: Two tertiary care rehabilitation hospitals in Italy. Subjects: Sixty-five adult subjects affected by spasticity of the wrist and finger flexors. Interventions: After injection with botulinum toxin type A, the group at hospital A (n = 33) was treated with adhesive taping for six days and those at hospital B (n = 32) with electrical stimulation and splinting for six days. Spastic hypertonia at the injected muscles was assessed before treatment, one week and one month post injection. Main measures: Modified Ashworth Scale. Results: In group A, the mean Modified Ashworth Scale reduction was 2.76±0.94 for wrist flexors and 2.45±0.92 for finger flexors; in group B the mean Modified Ashworth Scale reduction was 2.18±1.11 for wrist flexors and 2.1±0.98 for finger flexors. The observed difference between the two groups was statistically relevant (p<0.05). Conclusions: Patients treated with adhesive taping and botulinum toxin type A achieved a greater reduction in spastic hypertonia as measured with Modified Ashworth Scale, with less time dedicated for the treatment. [ABSTRACT FROM AUTHOR]