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Effects of Dynamic Stepping Training on Nonlocomotor Tasks in Individuals Poststroke

Don D. Straube, Carey L. Holleran, Catherine R. Kinnaird, Abigail L. Leddy, Patrick W. Hennessy, T. George Hornby
DOI: 10.2522/ptj.20130544 Published 1 July 2014
Don D. Straube
D.D. Straube, PT, PhD, NCS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, Illinois.
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Carey L. Holleran
C.L. Holleran, PT, MPT, NCS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.
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Catherine R. Kinnaird
C.R. Kinnaird, MS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.
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Abigail L. Leddy
A.L. Leddy, PT, DPT, MSCI, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.
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Patrick W. Hennessy
P.W. Hennessy, PT, DPT, NCS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.
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T. George Hornby
T.G. Hornby, PT, PhD, Sensory Motor Performance Program, Rehabilitation Institute of Chicago; Department of Physical Therapy and Kinesiology & Nutrition, University of Illinois at Chicago; and Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Mailing address: Department of Physical Therapy, University of Illinois, 1919 W Taylor St, Chicago, IL 60612 (USA).
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Figures

Figure 1.
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Figure 1.

CONSORT flow diagram of the study.

Figure 2.
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Figure 2.

Changes in clinical assessment of (A) Five-Times-Sit-to-Stand Test (5XSTS) scores and (B) Berg Balance Scale (BBS) scores at each assessment (baseline [BSL], mid-training [MID], posttraining [POST], and 3-month follow-up [F/U]), with an additional assessment of participants with chronic stroke 1 month prior to baseline (pre-baseline [PRE-BSL]). Improvements were significant from BSL assessment to MID, POST, and F/U, with no differences among the latter groups. **P<.01.

Figure 3.
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Figure 3.

Five-Times-Sit-to-Stand Test (5XSTS) representative trial for baseline (BSL) to posttraining assessment (POST) for 2 individuals classified as (A) severely impaired (self-selected speed <0.50 m/s) and (B) moderately impaired (self-selected speed=0.50–0.90 m/s). Tracings represents sacral marker vertical position (y-axis) versus time (x-axis), with gray arrows indicating start of successful ascent, black arrows indicating termination of ascent, and gray circles representing end descent. (C) Grouped data for total time, ascent time, descent time, and sitting time. *P<.05, **P<.01.

Figure 4.
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Figure 4.

Knee and hip power profiles for paretic and nonparetic lower extremities for a representative participant: average over the 5 repeated, successful sit-to-stand attempts. (A) paretic knee, (B) nonparetic knee, (C) paretic hip, (D) nonparetic hip. BSL=baseline, POST=postintervention.

Tables

Table 1.
Table 1.

Demographic and Baseline Locomotor Assessments in Participants With Subacute and Chronic Strokea

  • ↵a Measurements are presented as number of participants or X±SD.

Table 2.
Table 2.

Correlation Coefficients of Changes in Five-Times-Sit-to-Stand Test (5XSTS) Scores and Primary Locomotor and Nonlocomotor Outcomes Reported Previously With Secondary Measures of Balance (Berg Balance Scale [BBS]) and Paretic Limb Strengtha

  • ↵a P value from Pearson or Spearman correlations as warranted shown in parentheses. SSS=self-selected speed, FS=fastest speed.

Supplementary Data

eTable and eFigure

Files in this Data Supplement:

  • eTable and eFigure (PDF) (66 KB) - This PDF contains the following eTable and eFigure:
    • eTable. Joint Power and Extensor Moments During Sit-to-Stand Performance and Isometric Strength at Baseline, Change at Posttraining Assessment, and 95% Confidence Intervals.
    • eFigure. Correlations between (A) change in Five-Times-Sit-to-Stand Test (5XSTS) scores and change in Berg Balance Scale scores and (B) change in 5XSTS scores and change in hip extensor strength.
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Vol 94 Issue 7 Table of Contents
Physical Therapy: 94 (7)

Issue highlights

  • Dosing in Children With Brain Injury or Cerebral Palsy
  • Effects of Stepping Training on Nonlocomotor Skills
  • Physical Therapists' Clinical Knowledge of Multidisciplinary Low Back Pain Treatment Guidelines
  • Lower Extremity Muscle Strength and All-Cause Mortality in Japanese Patients Undergoing Dialysis
  • Muscle Weakness Poststroke
  • Clinical Identifiers for Early-Stage Primary/Idiopathic Adhesive Capsulitis
  • Hierarchical Properties of the Fugl-Meyer Assessment Scale in Acute and Chronic Stroke
  • Lower-Extremity Range-of-Motion Measurements in Children With Cerebral Palsy
  • Modified Dynamic Gait Index
  • A Simple Discharge Planning Tool Following Hospital Admission for an Isolated Lower Limb Fracture
  • Application of LSVT BIG Intervention in Parkinson Disease
  • Unilateral Vestibular Damage and the Musculoskeletal System
  • Human Movement System
  • Continuum of Care
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Effects of Dynamic Stepping Training on Nonlocomotor Tasks in Individuals Poststroke
Don D. Straube, Carey L. Holleran, Catherine R. Kinnaird, Abigail L. Leddy, Patrick W. Hennessy, T. George Hornby
Physical Therapy Jul 2014, 94 (7) 921-933; DOI: 10.2522/ptj.20130544

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Effects of Dynamic Stepping Training on Nonlocomotor Tasks in Individuals Poststroke
Don D. Straube, Carey L. Holleran, Catherine R. Kinnaird, Abigail L. Leddy, Patrick W. Hennessy, T. George Hornby
Physical Therapy Jul 2014, 94 (7) 921-933; DOI: 10.2522/ptj.20130544
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