Immediate effect of voluntary-induced stepping response training on protective stepping in persons with chronic stroke : a randomized controlled trial

Chayasit, P; Hollands, K; Hollands, M; Boonsinsukh, R

Abstract

Purpose: To compare the immediate effects of voluntary-induced stepping response training (VSR) and DynSTABLE perturbation training (DST) on protective stepping in patients with stroke.

Methods: A randomized controlled trial (registration number: TCTR20170827001) was conducted in 34 patients with chronic stroke who were randomly allocated to the VSR (n = 17) or DST (n = 17) group. The VSR group was instructed to lean forward to induce protective stepping, while the DST group experienced support surface translation. All participants received one session of training (3 set, 10 min for each set with 10-minute rest in between). Step length, step width, number of steps and center of mass (CoM) position during protective stepping were assessed using a computer-assisted rehabilitation environment (CAREN) system prior to and immediately after training. Two-way ANOVA was used to compare between groups and times.

Results: Both types of training resulted in an increase in step width, but step length increased and there was a more positive COM position exhibited following DST (p < .05) than following VSR. Single-step incidence increased, whereas multiple-step incidence decreased significantly in both groups. Only participants in the VSR group generated protective stepping with the affected leg in a larger percentage of trials (27%) after training than before training.

Conclusion: Both DST and VSR led to changes in protective stepping parameters after a single session of training. VSR may be a feasible alternative to equipment-based training but requires further study.

Citation

Chayasit, P., Hollands, K., Hollands, M., & Boonsinsukh, R. (2022). Immediate effect of voluntary-induced stepping response training on protective stepping in persons with chronic stroke : a randomized controlled trial. Disability and Rehabilitation, 44(3), 420-427. https://doi.org/10.1080/09638288.2020.1769205

• Journal Article Type: Article
• Acceptance Date: May 11, 2020
• Online Publication Date: Jun 1, 2020
• Publication Date: Jan 30, 2022
• Deposit Date: Jun 2, 2020
• Publicly Available Date: Jun 1, 2021
• Journal: Disability and Rehabilitation
• Print ISSN: 0963-8288
• Electronic ISSN: 1464-5165
• Publisher: Taylor and Francis
• Volume: 44
• Issue: 3
• Pages: 420-427
• DOI: https://doi.org/10.1080/09638288.2020.1769205
• Publisher URL: https://doi.org/10.1080/09638288.2020.1769205
• Related Public URLs: http://www.tandfonline.com/toc/idre20/current
• Additional Information: Access Information : This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 1st June 2020, available online: http://www.tandfonline.com/10.1080/09638288.2020.1769205; Funders : Thailand Research Fund; Grant Number: PHD/0076/2558