Abstract des Autors

Objective: To compare the gait of hemiparetic subjects walking on a treadmill with various body weight supports and walking on the floor. Design: Hemiparetic subjects walked on a treadmill, secured in a harness, with no body weight support and with 15% and 30% body weight relief, and walked on a floor. Setting: Kinematic laboratory of a department of rehabilitation. Subjects: Eighteen hemiparetic stroke patients. Main Outcome Measures: Gait cycle parameters and kinesiologic electromyogram of six muscles of the affected side and of two muscles of the nonaffected side. Results: On the treadmill, patients walked more slowly because of a reduced cadence, with a longer single stance period of the paretic limb, more symmetrically, and with a larger hip extension (multivariate profile analysis, p<.05). The mean functional activities of the gastrocnemius muscle and of the first crest of the erector spinae of the paretic side were smaller on the treadmill (univariate test, p<.05). Further, the premature activity of the gastrocnemius muscle, indicating spasticity, was less on the treadmill (univariate test, p<.05); correspondingly the qualitative muscle pattern analysis revealed less co-contraction between the gastrocnemius and tibialis anterior muscles in 11 of the 18 subjects. Conclusions: Treadmill training with partial body weight support in hemiparetic subjects allows them to practice a favorable gait characterized by a greater stimulus for balance training because of the prolonged single stance period of the affected limb, a higher symmetry, less plantar flexor spasticity, and a more regular activation pattern of the shank muscles as compared with floor walking. Verf.-Referat