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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Training Rapid Stepping Responses in an Individual With Stroke</title><author><name sortKey="Mansfield, Avril" sort="Mansfield, Avril" uniqKey="Mansfield A" first="Avril" last="Mansfield">Avril Mansfield</name><affiliation><nlm:aff id="aff1">A. Mansfield, PhD, is Postdoctoral Fellow, Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, and Postdoctoral Fellow, Balance Mobility and Falls Clinic and Mobility Team, Toronto Rehabilitation Institute, Toronto, Ontario, Canada. Mailing address: Toronto Rehabilitation Institute, 550 University Ave, Toronto, Ontario, M5A 2G2 Canada.</nlm:aff></affiliation></author><author><name sortKey="Inness, Elizabeth L" sort="Inness, Elizabeth L" uniqKey="Inness E" first="Elizabeth L." last="Inness">Elizabeth L. Inness</name><affiliation><nlm:aff id="aff2">E.L. Inness, MSc, BScPT, is Physiotherapist and Leader of the Balance Mobility and Falls Clinic, Toronto Rehabilitation Institute; a PhD candidate at the Graduate Department of Rehabilitation Sciences, University of Toronto, Toronto, Ontario, Canada, and the Mobility Team, Toronto Rehabilitation Institute; and Lecturer, Department of Physical Therapy, University of Toronto.</nlm:aff></affiliation></author><author><name sortKey="Komar, Janice" sort="Komar, Janice" uniqKey="Komar J" first="Janice" last="Komar">Janice Komar</name><affiliation><nlm:aff id="aff3">J. Komar, BScPT, is Physiotherapist, Neurorehabilitation Program, Stroke Service, Toronto Rehabilitation Institute.</nlm:aff></affiliation></author><author><name sortKey="Biasin, Louis" sort="Biasin, Louis" uniqKey="Biasin L" first="Louis" last="Biasin">Louis Biasin</name><affiliation><nlm:aff id="aff4">L. Biasin, BScPT, is Physiotherapist, Neurorehabilitation Program, Stroke Service, and the Balance Mobility and Falls Clinic, Toronto Rehabilitation Institute.</nlm:aff></affiliation></author><author><name sortKey="Brunton, Karen" sort="Brunton, Karen" uniqKey="Brunton K" first="Karen" last="Brunton">Karen Brunton</name><affiliation><nlm:aff id="aff5">K. Brunton, BScPT, is Clinical Educator and Physiotherapist, Balance Mobility and Falls Clinic, Toronto Rehabilitation Institute, and Lecturer, Department of Physical Therapy, University of Toronto.</nlm:aff></affiliation></author><author><name sortKey="Lakhani, Bimal" sort="Lakhani, Bimal" uniqKey="Lakhani B" first="Bimal" last="Lakhani">Bimal Lakhani</name><affiliation><nlm:aff id="aff6">B. Lakhani, MSc, is a PhD candidate at the Graduate Department of Rehabilitation Sciences, University of Toronto, and the Mobility Team, Toronto Rehabilitation Institute.</nlm:aff></affiliation></author><author><name sortKey="Mcilroy, William E" sort="Mcilroy, William E" uniqKey="Mcilroy W" first="William E." last="Mcilroy">William E. Mcilroy</name><affiliation><nlm:aff id="aff7">W.E. McIlroy, PhD, is Professor of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada; Senior Scientist, Balance Mobility and Falls Clinic and Mobility Team, Toronto Rehabilitation Institute; and Senior Scientist and Co-Site Director, Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre.</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21511992</idno><idno type="pmc">3107441</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107441</idno><idno type="RBID">PMC:3107441</idno><idno type="doi">10.2522/ptj.20100212</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">000366</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000366</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Training Rapid Stepping Responses in an Individual With Stroke</title><author><name sortKey="Mansfield, Avril" sort="Mansfield, Avril" uniqKey="Mansfield A" first="Avril" last="Mansfield">Avril Mansfield</name><affiliation><nlm:aff id="aff1">A. Mansfield, PhD, is Postdoctoral Fellow, Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, and Postdoctoral Fellow, Balance Mobility and Falls Clinic and Mobility Team, Toronto Rehabilitation Institute, Toronto, Ontario, Canada. Mailing address: Toronto Rehabilitation Institute, 550 University Ave, Toronto, Ontario, M5A 2G2 Canada.</nlm:aff></affiliation></author><author><name sortKey="Inness, Elizabeth L" sort="Inness, Elizabeth L" uniqKey="Inness E" first="Elizabeth L." last="Inness">Elizabeth L. Inness</name><affiliation><nlm:aff id="aff2">E.L. Inness, MSc, BScPT, is Physiotherapist and Leader of the Balance Mobility and Falls Clinic, Toronto Rehabilitation Institute; a PhD candidate at the Graduate Department of Rehabilitation Sciences, University of Toronto, Toronto, Ontario, Canada, and the Mobility Team, Toronto Rehabilitation Institute; and Lecturer, Department of Physical Therapy, University of Toronto.</nlm:aff></affiliation></author><author><name sortKey="Komar, Janice" sort="Komar, Janice" uniqKey="Komar J" first="Janice" last="Komar">Janice Komar</name><affiliation><nlm:aff id="aff3">J. Komar, BScPT, is Physiotherapist, Neurorehabilitation Program, Stroke Service, Toronto Rehabilitation Institute.</nlm:aff></affiliation></author><author><name sortKey="Biasin, Louis" sort="Biasin, Louis" uniqKey="Biasin L" first="Louis" last="Biasin">Louis Biasin</name><affiliation><nlm:aff id="aff4">L. Biasin, BScPT, is Physiotherapist, Neurorehabilitation Program, Stroke Service, and the Balance Mobility and Falls Clinic, Toronto Rehabilitation Institute.</nlm:aff></affiliation></author><author><name sortKey="Brunton, Karen" sort="Brunton, Karen" uniqKey="Brunton K" first="Karen" last="Brunton">Karen Brunton</name><affiliation><nlm:aff id="aff5">K. Brunton, BScPT, is Clinical Educator and Physiotherapist, Balance Mobility and Falls Clinic, Toronto Rehabilitation Institute, and Lecturer, Department of Physical Therapy, University of Toronto.</nlm:aff></affiliation></author><author><name sortKey="Lakhani, Bimal" sort="Lakhani, Bimal" uniqKey="Lakhani B" first="Bimal" last="Lakhani">Bimal Lakhani</name><affiliation><nlm:aff id="aff6">B. Lakhani, MSc, is a PhD candidate at the Graduate Department of Rehabilitation Sciences, University of Toronto, and the Mobility Team, Toronto Rehabilitation Institute.</nlm:aff></affiliation></author><author><name sortKey="Mcilroy, William E" sort="Mcilroy, William E" uniqKey="Mcilroy W" first="William E." last="Mcilroy">William E. Mcilroy</name><affiliation><nlm:aff id="aff7">W.E. McIlroy, PhD, is Professor of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada; Senior Scientist, Balance Mobility and Falls Clinic and Mobility Team, Toronto Rehabilitation Institute; and Senior Scientist and Co-Site Director, Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre.</nlm:aff></affiliation></author></analytic><series><title level="j">Physical Therapy</title><idno type="ISSN">0031-9023</idno><idno type="eISSN">1538-6724</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background and Purpose</title><p>Compensatory stepping reactions are important responses to prevent a fall following a postural perturbation. People with hemiparesis following a stroke show delayed initiation and execution of stepping reactions and often are found to be unable to initiate these steps with the more-affected limb. This case report describes a targeted training program involving repeated postural perturbations to improve control of compensatory stepping in an individual with stroke.</p></sec><sec><title>Case Description</title><p>Compensatory stepping reactions of a 68-year-old man were examined 52 days after left hemorrhagic stroke. He required assistance to prevent a fall in all trials administered during his initial examination because he showed weight-bearing asymmetry (with more weight borne on the more-affected right side), was unable to initiate stepping with the right leg (despite blocking of the left leg in some trials), and demonstrated delayed response times. The patient completed 6 perturbation training sessions (30–60 minutes per session) that aimed to improve preperturbation weight-bearing symmetry, to encourage stepping with the right limb, and to reduce step initiation and completion times.</p></sec><sec><title>Outcomes</title><p>Improved efficacy of compensatory stepping reactions with training and reduced reliance on assistance to prevent falling were observed. Improvements were noted in preperturbation asymmetry and step timing. Blocking the left foot was effective in encouraging stepping with the more-affected right foot.</p></sec><sec><title>Discussion</title><p>This case report demonstrates potential short-term adaptations in compensatory stepping reactions following perturbation training in an individual with stroke. Future work should investigate the links between improved compensatory step characteristics and fall risk in this vulnerable population.</p></sec></div></front></TEI><pmc article-type="case-report"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Phys Ther</journal-id><journal-id journal-id-type="hwp">ptjournal</journal-id><journal-id journal-id-type="pmc">ptjournal</journal-id><journal-id journal-id-type="publisher-id">PTJOURNAL</journal-id><journal-title-group><journal-title>Physical Therapy</journal-title></journal-title-group><issn pub-type="ppub">0031-9023</issn><issn pub-type="epub">1538-6724</issn><publisher><publisher-name>American Physical Therapy Association</publisher-name><publisher-loc>Alexandria, VA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21511992</article-id><article-id pub-id-type="pmc">3107441</article-id><article-id pub-id-type="publisher-id">2010-0212</article-id><article-id pub-id-type="doi">10.2522/ptj.20100212</article-id><article-categories><subj-group subj-group-type="hwp-journal-coll"><subject>804</subject><subject>1303</subject><subject>1505</subject><subject>1513</subject><subject>2600</subject></subj-group><subj-group subj-group-type="heading"><subject>Case Reports</subject></subj-group></article-categories><title-group><article-title>Training Rapid Stepping Responses in an Individual With Stroke</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Mansfield</surname><given-names>Avril</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Inness</surname><given-names>Elizabeth L.</given-names></name><xref ref-type="aff" rid="aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Komar</surname><given-names>Janice</given-names></name><xref ref-type="aff" rid="aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Biasin</surname><given-names>Louis</given-names></name><xref ref-type="aff" rid="aff4"></xref></contrib><contrib contrib-type="author"><name><surname>Brunton</surname><given-names>Karen</given-names></name><xref ref-type="aff" rid="aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Lakhani</surname><given-names>Bimal</given-names></name><xref ref-type="aff" rid="aff6"></xref></contrib><contrib contrib-type="author"><name><surname>McIlroy</surname><given-names>William E.</given-names></name><xref ref-type="aff" rid="aff7"></xref></contrib><aff id="aff1">A. Mansfield, PhD, is Postdoctoral Fellow, Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, and Postdoctoral Fellow, Balance Mobility and Falls Clinic and Mobility Team, Toronto Rehabilitation Institute, Toronto, Ontario, Canada. Mailing address: Toronto Rehabilitation Institute, 550 University Ave, Toronto, Ontario, M5A 2G2 Canada.</aff><aff id="aff2">E.L. Inness, MSc, BScPT, is Physiotherapist and Leader of the Balance Mobility and Falls Clinic, Toronto Rehabilitation Institute; a PhD candidate at the Graduate Department of Rehabilitation Sciences, University of Toronto, Toronto, Ontario, Canada, and the Mobility Team, Toronto Rehabilitation Institute; and Lecturer, Department of Physical Therapy, University of Toronto.</aff><aff id="aff3">J. Komar, BScPT, is Physiotherapist, Neurorehabilitation Program, Stroke Service, Toronto Rehabilitation Institute.</aff><aff id="aff4">L. Biasin, BScPT, is Physiotherapist, Neurorehabilitation Program, Stroke Service, and the Balance Mobility and Falls Clinic, Toronto Rehabilitation Institute.</aff><aff id="aff5">K. Brunton, BScPT, is Clinical Educator and Physiotherapist, Balance Mobility and Falls Clinic, Toronto Rehabilitation Institute, and Lecturer, Department of Physical Therapy, University of Toronto.</aff><aff id="aff6">B. Lakhani, MSc, is a PhD candidate at the Graduate Department of Rehabilitation Sciences, University of Toronto, and the Mobility Team, Toronto Rehabilitation Institute.</aff><aff id="aff7">W.E. McIlroy, PhD, is Professor of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada; Senior Scientist, Balance Mobility and Falls Clinic and Mobility Team, Toronto Rehabilitation Institute; and Senior Scientist and Co-Site Director, Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre.</aff></contrib-group><author-notes><corresp>Address all correspondence to Dr Mansfield at <email>avril.mansfield@utoronto.ca</email>.</corresp></author-notes><pub-date pub-type="ppub"><month>6</month><year>2011</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>12</month><year>2011</year></pub-date><pmc-comment> PMC Release delay is 6 months and 0 days and was based on the
<volume>91</volume><issue>6</issue><fpage>958</fpage><lpage>969</lpage><history><date date-type="received"><day>22</day><month>6</month><year>2010</year></date><date date-type="accepted"><day>21</day><month>2</month><year>2011</year></date></history><permissions><copyright-statement>© 2011 American Physical Therapy Association</copyright-statement><copyright-year>2011</copyright-year></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="zad00611000958.pdf"></self-uri><abstract><sec><title>Background and Purpose</title><p>Compensatory stepping reactions are important responses to prevent a fall following a postural perturbation. People with hemiparesis following a stroke show delayed initiation and execution of stepping reactions and often are found to be unable to initiate these steps with the more-affected limb. This case report describes a targeted training program involving repeated postural perturbations to improve control of compensatory stepping in an individual with stroke.</p></sec><sec><title>Case Description</title><p>Compensatory stepping reactions of a 68-year-old man were examined 52 days after left hemorrhagic stroke. He required assistance to prevent a fall in all trials administered during his initial examination because he showed weight-bearing asymmetry (with more weight borne on the more-affected right side), was unable to initiate stepping with the right leg (despite blocking of the left leg in some trials), and demonstrated delayed response times. The patient completed 6 perturbation training sessions (30–60 minutes per session) that aimed to improve preperturbation weight-bearing symmetry, to encourage stepping with the right limb, and to reduce step initiation and completion times.</p></sec><sec><title>Outcomes</title><p>Improved efficacy of compensatory stepping reactions with training and reduced reliance on assistance to prevent falling were observed. Improvements were noted in preperturbation asymmetry and step timing. Blocking the left foot was effective in encouraging stepping with the more-affected right foot.</p></sec><sec><title>Discussion</title><p>This case report demonstrates potential short-term adaptations in compensatory stepping reactions following perturbation training in an individual with stroke. Future work should investigate the links between improved compensatory step characteristics and fall risk in this vulnerable population.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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