Abstract
To evaluate the efficacy of electromechanical gait training (EGT) versus treadmill training with partial body weight support (TTPBWS) on lower limb motor performance (MP) and on motor evoked potential (MEP) in patients with chronic stroke. Fifty patients (age 43–75 years) with hemiparetic stroke (7–72 months’ duration) were allocated randomly to two groups. Patients of group I (n = 25) received EGT and those of group II (n = 25) received TTPBWS (20 min/day, 6 days/week for 8 weeks). Main outcome measurements: Fugel-Meyer lower extremity (FMLE) MP test and MEP were assessed in all patients before rehabilitation (A-begin), at the end of rehabilitation (A-end), and 3 months later (A-3m). By transcranial magnetic stimulation, MEP threshold, MEP amplitude (MEPamp), and cortical latencies to the rectus femoris, tibialis anterior, and gastrocnemius (GC) muscles were assessed. Better improvement in FMLE was observed in group I compared with group II. In group I, FMLE scores improved significantly at A-3m compared with A-end. A significant reduction in GC cortical latencies and increase in GC MEPamp on the second and third follow-up were observed in group I compared with group II. Although all MEP parameters of the three lower limb muscles tested improved throughout the follow-up periods on intragroup compression, they did not reach statistically significant levels. More patients in group I (unlike group II) with unobtainable MEP at A-begin had obtainable MEP at A-end and A-3m from rectus femoris and GC muscles. The change in MEPamp was the most frequent MEP variable that correlated with the change in FMLE scores (in either group). Better improvement in MP was observed following EGT at A-3m. Therefore, one EGT rather than TTPBWS may be recommended to improve lower extremity MP in chronic ambulatory stroke patients.
Highlights
Classic models of stroke recovery indicate that motor function improvements plateau between 3 and 6 months [1]
A significant reduction in GC cortical latencies and increase in GC MEP amplitude (MEPamp) on the second and third follow-up were observed in group I compared with group II
More patients in group I with unobtainable motor evoked potential (MEP) at at the beginning of the study (A-begin) had obtainable MEP at at the end of rehabilitation (A-end) and A-3m from rectus femoris and GC muscles
Summary
Classic models of stroke recovery indicate that motor function improvements plateau between 3 and 6 months [1]. Basic repetitive motor learning strategies can alter underlying neural mechanisms to improve the function of the lower limb and may be effective in recovery of walking ability and restoration of independent gait in hemiparetic stroke patients. The major disadvantage of TTPBWS is the effort required by two therapists to assist gait of the patients. In a previous study [5] comparing the efficacy of EGT with that of TTPBWS on lower limb functional outcome in unambulatory patients with subacute stroke, no significant differences in the outcome were found between the two methods, and it was concluded that EGT was at least as effective as TTPBWS, while requiring less input from the therapist. Therapeutic effects of gait rehabilitation through task-specific repetitive training have been evaluated using functional scores (i.e.function ambulatory category) or by analysis of gait events
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
