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Affiliation
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Department of Rehabilitation Medicine, Vrije Universiteit, Amsterdam Movement Sciences, Amsterdam, the Netherlands. |
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Abstract
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BACKGROUND: Treadmill training augmented with visual images projected on the belt's surface may help improve walking adaptability. Moreover, patient-tailored automatization and standardization may increase the feasibility of walking-adaptability therapy. We developed C-Gait, a treadmill protocol consisting of a baseline walking-adaptability assessment involving seven putatively distinct walking-adaptability tasks and a decision-algorithm to automatically update training content and execution parameters to patients' performance and perceived challenge.
OBJECTIVES: The main objective was to examine the feasibility, acceptability, and clinical potential of C-Gait training. The secondary objective was to evaluate the validity of the baseline assessment.
DESIGN: This was a longitudinal proof-of-concept study with pre-training, post-training, and retention tests (baseline assessment and walking-related clinical measures).
METHODS: Twenty-four healthy adults, 12 healthy elderly, and 28 patients with gait and/or balance deficits (GD) performed the baseline assessment; the GD group received 10 C-Gait training sessions over a 5-week period. Baseline assessment scores and walking-related clinical measures served as outcome measures.
RESULTS: C-Gait training exhibited significant progression in training content and execution, with considerable between-patient variation and minimal overruling by therapists. C-Gait training was well accepted and led to improvements in walking adaptability and general walking ability, which prevailed at retention. Baseline assessment scores differed over groups and difficulty levels, had no to moderate correlations with walking-related clinical measures, and had limited correlations among walking-adaptability tasks. LIMITATIONS: C-Gait was evaluated in a small yet diverse cohort. More encompassing studies are required to further establish its apparent merits. The validity of treadmill-based walking-adaptability assessment against an overground standard remains to be established.
CONCLUSIONS: C-Gait offers automatized, standardized, and patient-tailored walking-adaptability training, which is feasible and well accepted, with good potential for improving task-specific and generic measures of walking.
© 2019 American Physical Therapy Association.
Language: en |