Citation

Punt M, Bruijn SM, van de Port IG, de Rooij IJM, Wittink H, van Dieen JH. J. Appl. Biomech. 2019; 35(3): 173-181.

Affiliation

Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands.

Copyright

(Copyright © 2019, Human Kinetics Publishers)

DOI

10.1123/jab.2017-0282

PMID

30676147

Abstract

A recent review indicated that perturbation based training (PBT) interventions are effective in reducing falls in older adults and patients with Parkinson's disease. It is unknown whether this type of intervention is effective in stroke survivors. We determined whether PBT can enhance gait stability in stroke survivors. Ten chronic stroke survivors who experienced falls in the past six months participated in the PBT. Participants performed 10 training sessions over a six-week period. The gait training protocol was progressive and each training contained, unexpected gait perturbations and expected gait perturbations. Evaluation of gait stability was performed by determining steady-state gait characteristics and daily-life gait characteristics. We previously developed fall prediction models for both gait assessment methods. We evaluated whether predicted fall risk was reduced after PBT according to both models. Steady-state gait characteristics significantly improved and consequently predicted fall risk was reduced after the PBT. Daily-life gait characteristics, however, did not change and thus predicted fall risk based on daily-life gait remained unchanged after the PBT. A PBT resulted in more stable gait on a treadmill and thus lower predicted fall risk. However, the more stable gait on the treadmill did not transfer to a more stable gait in daily life.

Language: en

Keywords

falls; gait; perturbations; stability; stroke