Targeted training of the function of walking according to the stance and single support phase in patients in the early recovery period of cerebral stroke

Abstract

Background: The phases of support and single support on a limb are significant basic parameters of walking (phase of support means the whole limb support time, while the phase of single support is when only one limb is on the ground). Both can be used as targets for biofeedback training. Aim: to investigate the effectiveness of both target parameters for training the function of walking with biofeedback in patients in the early recovery period of cerebral stroke. Methods: The study involved 40 patients, 20 in each group, who underwent a training course to harmonize walking: the first group for the period of support, and the second group for the period of single support. The control group of healthy people also consisted of 20 people. We studied the spatiotemporal parameters of walking at an arbitrary pace at the beginning and after the end of the training course, as well as classical clinical scales. The treadmill training consisted of 10 sessions. Results: The clinical and biomechanical parameters of walking changed their values in the direction of a significant improvement in the performance. At the same time, the biomechanical parameters of the second group indicated a more severe functional state before the start of the treatment, with the same clinical parameters according to the Barthel scale, Rivermead Mobility Index, modified Rankin scale, rehabilitation routing scale, and manual muscle testing. In the first group, indirect data were obtained on the possible effect of the target indicator on the training and direct data on its effect on the function of a healthy limb, which also allows increasing the load on the paretic one. In the second group, there were no reliable data on the effect of biofeedback training on the functional outcome. Conclusion: The conducted study showed that the classical clinical assessment of the patient's condition may not correspond to the instrumental functional study of walking. When using the support period as the training target parameter, indirect evidence was obtained that such a training is effective.