A systematic review of mechanisms of gait speed change post-stroke. Part 2: exercise capacity, muscle activation, kinetics, and kinematics
| Autor: | Elizabeth C. Wonsetler, Mark G. Bowden |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
030506 rehabilitation
medicine.medical_specialty medicine.medical_treatment Walking CINAHL Kinematics Electromyography Article 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Humans Medicine skin and connective tissue diseases Stroke Gait Disorders Neurologic Community and Home Care Rehabilitation medicine.diagnostic_test business.industry Stroke Rehabilitation Recovery of Function Exercise capacity medicine.disease Gait Biomechanical Phenomena Preferred walking speed Physical therapy sense organs Neurology (clinical) 0305 other medical science business 030217 neurology & neurosurgery |
| Zdroj: | Topics in Stroke Rehabilitation. 24:394-403 |
| ISSN: | 1945-5119 1074-9357 |
| DOI: | 10.1080/10749357.2017.1282413 |
| Popis: | Regaining locomotor ability is a primary goal in stroke rehabilitation and is most commonly measured using changes in self-selected walking speed. However, walking speed cannot identify the mechanisms by which an individual recovers. Laboratory-based mechanistic measures such as exercise capacity, muscle activation, force production, and movement analysis variables may better explain neurologic recovery.The objectives of this systematic review are to examine changes in mechanistic gait outcomes and describe motor recovery as quantified by changes in laboratory-based mechanistic variables in rehabilitation trials.Following a systematic literature search (in PubMed, Ovid, and CINAHL), we included rehabilitation trials with a statistically significant change in self-selected walking speed post-intervention that concurrently collected mechanistic variables. Methodological quality was assessed using Cochrane Collaboration's tool. Walking speed changes, mechanistic variables, and intervention data were extracted.Twenty-five studies met the inclusion criteria and examined: cardiorespiratory function (n = 5), muscle activation (n = 5), force production (n = 11), and movement analysis (n = 10). Interventions included: aerobic training, functional electrical stimulation, multidimensional rehabilitation, robotics, sensory stimulation training, strength/resistance training, task-specific locomotor rehabilitation, and visually-guided training.Following this review, no set of outcome measures to mechanistically explain changes observed in walking speed were identified. Nor is there a theoretical basis to drive the complicated selection of outcome measures, as many of these outcomes are not independent of walking speed. Since rehabilitation literature is yet to support a causal, mechanistic link for functional gains post-stroke, a systematic, multimodal approach to stroke rehabilitation will be necessary in doing so. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|