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PLoS One. 2015 Oct 7;10(10):e0139261. doi: 10.1371/journal.pone.0139261. eCollection 2015.

Feasibility and Preliminary Efficacy of Visual Cue Training to Improve Adaptability of Walking after Stroke: Multi-Centre, Single-Blind Randomised Control Pilot Trial.

Author information

1
School of Health Sciences, University of Salford, Allerton Building, Salford, M6 6PU, United Kingdom.
2
Colleges of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
3
Birmingham Community Health Care NHS Trust, (BCHCT), Moseley Hall Hospital, Birmingham, B13 8JL, United Kingdom.
4
University of Nottingham, Nottingham Clinical Trials Unit, Nottingham Health Science Partners, C-floor, South Block, Queen's Medical Centre, Nottingham, NG7 2UH, United Kingdom.
5
College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
6
King's College London, Capital House, Guy's Campus, London, SE1 3QD, United Kingdom.
7
School of Nursing, Midwifery & Social Work, University of Manchester,Oxford Rd, Manchester, M13 9PL, United Kingdom.
8
School of Health Sciences, Hunter Building, University Drive, University of Newcastle, Callaghn, New South Wales, 2308, Australia.

Abstract

OBJECTIVES:

Given the importance of vision in the control of walking and evidence indicating varied practice of walking improves mobility outcomes, this study sought to examine the feasibility and preliminary efficacy of varied walking practice in response to visual cues, for the rehabilitation of walking following stroke.

DESIGN:

This 3 arm parallel, multi-centre, assessor blind, randomised control trial was conducted within outpatient neurorehabilitation services.

PARTICIPANTS:

Community dwelling stroke survivors with walking speed <0.8m/s, lower limb paresis and no severe visual impairments.

INTERVENTION:

Over-ground visual cue training (O-VCT), Treadmill based visual cue training (T-VCT), and Usual care (UC) delivered by physiotherapists twice weekly for 8 weeks.

MAIN OUTCOME MEASURES:

Participants were randomised using computer generated random permutated balanced blocks of randomly varying size. Recruitment, retention, adherence, adverse events and mobility and balance were measured before randomisation, post-intervention and at four weeks follow-up.

RESULTS:

Fifty-six participants participated (18 T-VCT, 19 O-VCT, 19 UC). Thirty-four completed treatment and follow-up assessments. Of the participants that completed, adherence was good with 16 treatments provided over (median of) 8.4, 7.5 and 9 weeks for T-VCT, O-VCT and UC respectively. No adverse events were reported. Post-treatment improvements in walking speed, symmetry, balance and functional mobility were seen in all treatment arms.

CONCLUSIONS:

Outpatient based treadmill and over-ground walking adaptability practice using visual cues are feasible and may improve mobility and balance. Future studies should continue a carefully phased approach using identified methods to improve retention.

TRIAL REGISTRATION:

Clinicaltrials.gov NCT01600391.

PMID:
26445137
PMCID:
PMC4596478
DOI:
10.1371/journal.pone.0139261
[Indexed for MEDLINE]
Free PMC Article

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