Effects of overloading of the lower hemiparetic extremity on walking speed in chronic stroke patients: A pilot study

Boudewijn J. Kollen, Marc B. Rietberg, Gert Kwakkel, Cornelis H. Emmelot

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The objective of this pilot study was to investigate the carry-over effects on comfortable walking speed after overloading the lower hemiparetic extremity in chronic stroke patients. A single subject research study was conducted using a withdrawal design (A-B-A-B-A) on three patients with ischaemic middle cerebral artery infarction. Chronic stroke patients were recruited with stage 3 or 4 Fugl-Meyer scores in the lower extremity and the ability to ambulate independently without walking aids. Based on this withdrawal design, the daily procedure included walking at comfortable speeds 5 x 10 meters during the A1 phase and 3 x 10 meters during all subsequent phases. This procedure was repeated for five consecutive days. Two lbs (B1) and 6 lbs (B2) weight cuffs were attached to the distal lower hemiparetic extremity and randomized over the two B phases. Control (A1, A2, A3) and intervention (B1, B2) phases were alternated with brief resting periods. Mean comfortable walking speed for 10 meters constituted the outcome variable. All patients showed significant differences between phases (χ2 = 34.187; p < 0.001). However, with the exception of a carry-over effect between the A1 (0.86 m/sec) and A2 (0.89 m/sec) phases in one subject (p = 0.043) no significant carry-over effects were found on ensuing A2 and A3 control phases. Although gradual improvements in comfortable walking speed between subsequent days were found the present pilot study did not demonstrate favorable group effects on comfortable walking speed as a result of limb overloading.

Original languageEnglish
Pages (from-to)159-164
Number of pages6
Issue number3
Publication statusPublished - 19 Sept 2000


  • Hemiplegia
  • Overloading
  • Physical therapy
  • Stroke rehabilitation
  • Weights

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