Gait training and assessment in rehabilitation after stroke

Research output: Doctoral thesisThesis, fully internal

Abstract

Many stroke survivors suffer from limited walking ability due to an asymmetrical gait pattern and reduced gait capacity. Gait training assisted by multi-channel functional electrical stimulation (MFES gait training) applied to upper and lower leg muscles in early stroke rehabilitation might improve spatiotemporal gait symmetry. To this end, instruments with adequate measurement properties are required to objectively assess the intervention effect. Therefore, the aims of this thesis were (1) to increase the methodological knowledge of gait assessment post stroke; and (2) to determine whether MFES gait training, starting in the sub-acute phase after stroke, is feasible and enhances the recovery of spatiotemporal gait symmetry and gait capacity. First, from a systematic review on gait capacity tests and three cross-sectional studies (on the Shuttle Walk Test, Functional Gait Assessment, and Spatiotemporal Gait Analysis System), it was concluded that several valid and reliable tests are available to measure different aspects of gait capacity and spatiotemporal gait parameters in stroke survivors. Information on responsiveness and other measurement properties was lacking and should be investigated. Second, the results of a randomised controlled trial confirmed the feasibility of MFES gait training, but did not demonstrate a difference between MFES gait training and conventional gait training in gait symmetry and capacity. Although MFES gait training may not enhance the recovery of spatiotemporal gait symmetry or gait capacity in all stroke survivors during early rehabilitation, this does not preclude possible beneficial effects in a more targeted population with better potential for the restoration of spatiotemporal gait symmetry.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • University of Amsterdam
Supervisors/Advisors
  • Nollet, Frans, Supervisor
  • Geurts, A. C. H., Supervisor, External person
  • Beelen, Anita A. J. M., Co-supervisor
  • Bus, Sicco A., Co-supervisor
Award date22 Dec 2021
Print ISBNs9789464215335
Publication statusPublished - 2021

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