Timmermans, C.
Roerdink, M.
Meskers, C.G.M.
Beek, P.J.
Janssen, T.W.J.
2018-11-16
<p><strong>PURPOSE</strong>: The ability to adapt walking to environmental properties and hazards, a prerequisite for safe<br>
walking, is often impaired in persons after stroke. This study aimed to compare the efficacy of two walking adaptability<br>
interventions: treadmill-based C-Mill therapy (therapy with augmented reality) and the<br>
overground FALLS program (conventional therapy program using physical context). We hypothesized that,<br>
besides the difference in type of environmental context, C-Mill therapy would result in better outcomes<br>
than the FALLS program, owing to its expected greater amount of walking practice operationalized by the<br>
number of steps taken per session.<br>
<strong>METHODS</strong>: Within a randomized controlled trial with pre-intervention, post-intervention, retention and<br>
follow-up tests, 30 persons after stroke (≥3 months) with walking and/or balance deficits were randomly<br>
allocated to either 5 weeks of C-Mill therapy or the FALLS program. Outcome measures were walking<br>
speed and walking adaptability, using 10MWTs with or without physical context and a novel Interactive<br>
Walkway assessment with augmented context. A cognitive task was added to assess dual-task<br>
performance. The amount of walking practice was scored using the treadmill’s inbuilt step counter (C-Mill<br>
therapy) and video recordings (FALLS program).<br>
<strong>RESULTS</strong>: Both interventions showed significant improvements in walking speed, walking adaptability<br>
and cognitive dual-task performance when walking in enriched environments. Furthermore, C-Mill therapy<br>
showed a greater improvement in walking speed at the 10MWT with physical context compared to the<br>
FALLS program; however, this was no longer significant at retention. C-Mill therapy encompassed twice<br>
as many steps per session compared to a FALLS program session.<br>
<strong>CONCLUSIONS</strong>: Both C-Mill and FALLS training led to task-specific improvements in walking adaptability;<br>
the greater improvement in walking speed might be explained by the greater amount of walking practice<br>
during C-Mill therapy.</p>
https://doi.org/10.5281/zenodo.1489886
oai:zenodo.org:1489886
eng
Zenodo
https://zenodo.org/communities/rehabmove2018
https://doi.org/10.5281/zenodo.1489885
info:eu-repo/semantics/openAccess
Creative Commons Attribution Non Commercial No Derivatives 4.0 International
https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode
6th International RehabMove State-Of-The-Art Congress 2018, Groningen, The Netherlands, 12-14 December 2018
RehabMove 2018: WALKING ADAPTABILITY TRAINING IN PEOPLE AFTER STROKE: A RANDOMIZED CONTROLLED TRIAL
info:eu-repo/semantics/conferencePaper