Masood Nevisipour1, Mark D Grabiner2, Claire F Honeycutt3. 1. School for Engineering of Matter, Transport & Energy, Arizona State University, Tempe, AZ, USA. Electronic address: mnevisip@asu.edu. 2. Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA. Electronic address: grabiner@uic.edu. 3. School of Biological and Health System Engineering, Arizona State University, Tempe, AZ, USA. Electronic address: cfhoneyc@asu.edu.
Abstract
BACKGROUND: Individuals with stroke are at significant risk of falling. Trip-specific training is a targeted training approach that has been shown to reduce falls in older adults and amputees by enhancing the compensatory stepping response required to prevent a fall. Still, individuals with stroke have unique deficits (e.g. spasticity) which draws into question if this type of training will be effective for this population. OBJECTIVE: Evaluate if a single session of trip-specific training can modify the compensatory stepping response (trunk movement, step length/duration, reaction time) of individuals with chronic stroke. METHODS: Sixteen individuals with unilateral chronic stroke participated in a single session of trip-specific training consisting of 15 treadmill perturbations. A falls assessment consisting of 3 perturbations was completed before and after training. Recovery step kinematics measured during the pre- and post-test were compared using a repeated measures design. Furthermore, Fallers (those who experienced at least one fall during the pre- or post-test) were compared to Non-fallers. RESULTS: Trip-specific training decreased trunk movement post perturbation. Specifically following training, Trunk flexion was 48 and 19 percent smaller on the small and medium perturbations at the end of the first compensatory step. Fallers (9 out of 16 subjects) post-training resembled Non-Fallers pre-training. Specifically, Trunk flexion at the completion of the first step during small and medium perturbations was not different between Fallers post-training and Non-Fallers pre-training. Still enthusiasm was tempered because Trunk flexion at the largest perturbation (where most falls occurred) was not changed and therefore total falls were not reduced as a result of this training. SIGNIFICANCE: Our results indicate that trip-specific training modifies the dynamic falls response immediately following trip-like treadmill perturbations. However, the incidence of falls was not reduced with a single training session. Further study of the implications and length of the observed intervention effect are warranted.
BACKGROUND: Individuals with stroke are at significant risk of falling. Trip-specific training is a targeted training approach that has been shown to reduce falls in older adults and amputees by enhancing the compensatory stepping response required to prevent a fall. Still, individuals with stroke have unique deficits (e.g. spasticity) which draws into question if this type of training will be effective for this population. OBJECTIVE: Evaluate if a single session of trip-specific training can modify the compensatory stepping response (trunk movement, step length/duration, reaction time) of individuals with chronic stroke. METHODS: Sixteen individuals with unilateral chronic stroke participated in a single session of trip-specific training consisting of 15 treadmill perturbations. A falls assessment consisting of 3 perturbations was completed before and after training. Recovery step kinematics measured during the pre- and post-test were compared using a repeated measures design. Furthermore, Fallers (those who experienced at least one fall during the pre- or post-test) were compared to Non-fallers. RESULTS:Trip-specific training decreased trunk movement post perturbation. Specifically following training, Trunk flexion was 48 and 19 percent smaller on the small and medium perturbations at the end of the first compensatory step. Fallers (9 out of 16 subjects) post-training resembled Non-Fallers pre-training. Specifically, Trunk flexion at the completion of the first step during small and medium perturbations was not different between Fallers post-training and Non-Fallers pre-training. Still enthusiasm was tempered because Trunk flexion at the largest perturbation (where most falls occurred) was not changed and therefore total falls were not reduced as a result of this training. SIGNIFICANCE: Our results indicate that trip-specific training modifies the dynamic falls response immediately following trip-like treadmill perturbations. However, the incidence of falls was not reduced with a single training session. Further study of the implications and length of the observed intervention effect are warranted.
Authors: Bahman S Roudsari; Beth E Ebel; Phaedra S Corso; Noelle-Angelique M Molinari; Thomas D Koepsell Journal: Injury Date: 2005-11 Impact factor: 2.586
Authors: Mark D Grabiner; Mary Lou Bareither; Strawberry Gatts; Jane Marone; Karen L Troy Journal: Med Sci Sports Exerc Date: 2012-12 Impact factor: 5.411
Authors: Avril Mansfield; Alison Schinkel-Ivy; Cynthia J Danells; Anthony Aqui; Raabeae Aryan; Louis Biasin; Vincent G DePaul; Elizabeth L Inness Journal: J Stroke Cerebrovasc Dis Date: 2017-06-01 Impact factor: 2.136
Authors: Ruqayya Lockhart; Wiesław Błach; Manuela Angioi; Tadeusz Ambroży; Łukasz Rydzik; Nikos Malliaropoulos Journal: Int J Environ Res Public Health Date: 2022-04-02 Impact factor: 3.390
Authors: Nicholas K Reimold; Holly A Knapp; Alyssa N Chesnutt; Alexa Agne; Jesse C Dean Journal: IEEE Trans Neural Syst Rehabil Eng Date: 2021-02-26 Impact factor: 3.802