Does a Perturbation Based Gait Intervention Enhance Gait Stability in Fall Prone Stroke Survivors?: A Pilot Study

Michiel Punt, Sjoerd M Bruijn, Ingrid G van de Port, Ilona J M de Rooij, Harriet Wittink, Jaap H van Dieën

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

A recent review indicated that perturbation based training (PBT) interventions are effective in reducing falls in older adults and patients with Parkinson's disease. It is unknown whether this type of intervention is effective in stroke survivors. We determined whether PBT can enhance gait stability in stroke survivors. Ten chronic stroke survivors who experienced falls in the past six months participated in the PBT. Participants performed 10 training sessions over a six-week period. The gait training protocol was progressive and each training contained, unexpected gait perturbations and expected gait perturbations. Evaluation of gait stability was performed by determining steady-state gait characteristics and daily-life gait characteristics. We previously developed fall prediction models for both gait assessment methods. We evaluated whether predicted fall risk was reduced after PBT according to both models. Steady-state gait characteristics significantly improved and consequently predicted fall risk was reduced after the PBT. Daily-life gait characteristics, however, did not change and thus predicted fall risk based on daily-life gait remained unchanged after the PBT. A PBT resulted in more stable gait on a treadmill and thus lower predicted fall risk. However, the more stable gait on the treadmill did not transfer to a more stable gait in daily life.

LanguageEnglish
Pages1-26
Number of pages26
JournalJournal of Applied Biomechanics
DOIs
Publication statusE-pub ahead of print - 24 Jan 2019

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Gait
Survivors
Stroke
Parkinson Disease

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@article{4c55c6da83c8459d9ace85a8dfe0c9bd,
title = "Does a Perturbation Based Gait Intervention Enhance Gait Stability in Fall Prone Stroke Survivors?: A Pilot Study",
abstract = "A recent review indicated that perturbation based training (PBT) interventions are effective in reducing falls in older adults and patients with Parkinson's disease. It is unknown whether this type of intervention is effective in stroke survivors. We determined whether PBT can enhance gait stability in stroke survivors. Ten chronic stroke survivors who experienced falls in the past six months participated in the PBT. Participants performed 10 training sessions over a six-week period. The gait training protocol was progressive and each training contained, unexpected gait perturbations and expected gait perturbations. Evaluation of gait stability was performed by determining steady-state gait characteristics and daily-life gait characteristics. We previously developed fall prediction models for both gait assessment methods. We evaluated whether predicted fall risk was reduced after PBT according to both models. Steady-state gait characteristics significantly improved and consequently predicted fall risk was reduced after the PBT. Daily-life gait characteristics, however, did not change and thus predicted fall risk based on daily-life gait remained unchanged after the PBT. A PBT resulted in more stable gait on a treadmill and thus lower predicted fall risk. However, the more stable gait on the treadmill did not transfer to a more stable gait in daily life.",
author = "Michiel Punt and Bruijn, {Sjoerd M} and {van de Port}, {Ingrid G} and {de Rooij}, {Ilona J M} and Harriet Wittink and {van Die{\"e}n}, {Jaap H}",
year = "2019",
month = "1",
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language = "English",
pages = "1--26",
journal = "Journal of Applied Biomechanics",
issn = "1065-8483",
publisher = "Human Kinetics Publishers Inc.",

}

Does a Perturbation Based Gait Intervention Enhance Gait Stability in Fall Prone Stroke Survivors? A Pilot Study. / Punt, Michiel; Bruijn, Sjoerd M; van de Port, Ingrid G; de Rooij, Ilona J M; Wittink, Harriet; van Dieën, Jaap H.

In: Journal of Applied Biomechanics, 24.01.2019, p. 1-26.

Research output: Contribution to JournalArticleAcademicpeer-review

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AB - A recent review indicated that perturbation based training (PBT) interventions are effective in reducing falls in older adults and patients with Parkinson's disease. It is unknown whether this type of intervention is effective in stroke survivors. We determined whether PBT can enhance gait stability in stroke survivors. Ten chronic stroke survivors who experienced falls in the past six months participated in the PBT. Participants performed 10 training sessions over a six-week period. The gait training protocol was progressive and each training contained, unexpected gait perturbations and expected gait perturbations. Evaluation of gait stability was performed by determining steady-state gait characteristics and daily-life gait characteristics. We previously developed fall prediction models for both gait assessment methods. We evaluated whether predicted fall risk was reduced after PBT according to both models. Steady-state gait characteristics significantly improved and consequently predicted fall risk was reduced after the PBT. Daily-life gait characteristics, however, did not change and thus predicted fall risk based on daily-life gait remained unchanged after the PBT. A PBT resulted in more stable gait on a treadmill and thus lower predicted fall risk. However, the more stable gait on the treadmill did not transfer to a more stable gait in daily life.

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