Contribution of Paretic and Nonparetic Limb Peak Propulsive Forces to Changes in Walking Speed in Individuals Poststroke.
HaoYuan Hsiao, Louis N Awad, Jacqueline A Palmer and 2 others
PMID 26721869WHAT IT FOUND
After 12 weeks of gait training, paretic leg propulsion became the stronger predictor of faster self-selected walking speed, reducing reliance on the non-paretic leg.
However, non-paretic propulsion remained the primary driver for maximum speed. Assess both speeds to guide treatment.
Key findings
01Following gait training, changes in paretic propulsive force were a stronger independent predictor of increases in self-selected walking speed than changes in non-paretic propulsive force.
02Only changes in non-paretic propulsive force independently contributed to increases in faster walking speed after training, despite significant changes in paretic force.
03Before training, only non-paretic propulsive force independently predicted changes in walking speed during within-session speed modulation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Data from three different training interventions were combined, so it is unknown if one method was superior to another. Participants were allowed to use handrails for safety, which may have altered gait mechanics and force distribution. Results apply only to individuals able to walk for 6 minutes without orthotic support, excluding more severely impaired patients. The study was observational regarding mechanisms; it did not test the efficacy of the specific training protocols compared to each other.
Declared interests
None declared in the provided text. Funding was from NIH Extramural grants.
The easy way to misread this
Do not conclude that paretic limb training is sufficient for all speed goals. While paretic propulsion predicted self-selected speed gains after training, it failed to predict gains in faster walking speed, where non-paretic propulsion remained the sole independent predictor.