Barobiofeedback et rééducation de la marche de l'hémiplégique

Abstract

Aims. – To compare, in post-acute hemiparetic patients, gait improvement after conventional physical therapy alone or with a specialised balance retraining program. Patients. – Twenty-six patients within 3 months of onset of stroke were randomised to receive physical therapy (control group) or therapy and retraining (experimental group), most of the patients in both groups with left hemiplegia. The experimental group was significantly older than the control group. Method. – Thirteen patients received early conventional therapy, and 13 received therapy combined with standing balance training by biofeedback (BPM Monitor ®). Clinical measures were collected at entry (J0), once when subjects began to walk (JM) and 30 days later (JM + 30). Gait spatiotemporal parameters were collected by use of the Vicon ® system at JM and JM + 30. Results. – Whatever the method of rehabilitation, the clinical scores improved significantly between J0 and JM + 30, except for spasticity. The time between stroke and the beginning of walking was not significantly different between both groups. Gait velocity increased significantly between JM and JM + 30 in both groups, with no difference between groups. The walking pattern was improved for both groups, with a significant increase of the duration of the paretic limb single stance. The experimental group significantly improved the duration of the reception double stance on the paretic limb between JM and JM + 30 compared with the control group ( P = 0.03). Conclusion. – Both groups demonstrated improvement in the rehabilitation unit. The benefits of visual biofeedback by forceplate system training suggest particular improvement of anticipation equilibrium with conventional therapy.