Gait

Front 1

In some patients with mild stroke,

Back 1

The affected ankle plantarflexors were prematurely activated in the early stance phase, because of the enhanced stretch reflex.

Front 2

Because this premature contraction of the ankle plantarflexors may thrust the knee joint into hyperextension in the stance phase,

Back 2

Instead of propelling the body forward as in normal gait, the gait velocity of these patients was affected.

Front 3

However, other researchers have found that the degree of the spasticity of the affected ankle plantarflexors and knee axtensors

Back 3

Was not significantly related to the gait velocity of patients with mild to moderate spastic hemiparesis.

Front 4

Therefore, it remains unclear as to whether spasticity of the affected lower extremity

Back 4

Is the key factor influencing the gait velocity of these patients.

Front 5

Some investigators have shown moderate correlation

Back 5

Between standing balance and gait performance of patients with stroke of varying severity.

Front 6

However, reported no significant correlation between standing balance and maximal walking speed for patients with good standing balance ability

Back 6

That is those showing less than 30cm of center of foot pressure path in 10 seconds of standing.

Front 7

Standing balance training that led to better improvement in standing symmetry failed

Back 7

To result in greater improvement in hemiplegic gait symmetry of patients with moderate stroke.

Front 8

Whereas most research has focused on investigating

Back 8

The causes of slow gait velocity in patients with stroke. Less effort has been made to investigate the causes of gait asymmetry in these patients.

Front 9

The primary causes of gait asymmetry in patients with stroke

Back 9

Have yet to be determined.

Front 10

The purposes of our study were to investigate the association between several direct impairments and gait performance,

Back 10

Including gait velocity as well as temporal and spatial asymmetry in comfortable and fast- speed walking conditions, in patients with stroke, and to identify the most important direct impairments that determine gait velocity and asymmetry of these patients.

Front 11

The direct impairments investigated included

Back 11

Isokinetic muscle strength of the hip flexors, knee extensors, and ankle plantarflexors, motor recovery status, sensory function, and ankle plantarflexor spasticity of the affected lower extremity.

Front 12

FMA uses a cumulative numeric scoring system, with 17 motor and 6 sensory items

Back 12

For evaluating the lower extremity, each scored from 0 to 2.

A score of 0 indicates complete loss of sensory function or inability to perform a motor item.

A score of 2 indicates normal sensory function or ability to perform a designated movement to full range

Front 13

Demonstrated benefits in terms of improvement in function

Back 13

Have been less convincing.

Front 14

Remaining

Back 14

Among the RCTs, two included a placebo control, while the remaining studies used electrical stimulation or taping as a co- intervention; however, in these studies, subject in the control condition received botox only. Data from these three RCTs were treated as single- intervention studies.

Front 15

Gait velocity is not an ideal outcome measure, it was chosen as it is considered to be an effective indication of the degree of gait impairment and was commonly reported.

Back 15

Its limitations include the inability to capture improvement that may have occurred in gait quality, standing balance, satisfaction with treatment or the discontinued need for walking aids or orthoses.

Front 16

The decision to include single-group intervention trials and to treat the results from the single arm of an RCT as such helped to increase the number of studies available for analysis,

Back 16

But may have also led to an over- estimation of the treatment effect

Front 17

Threshold associated with full community ambulation

Back 17

Is 0.8 m/s