Deans' stroke musings: Effect of bilateral step-up and -down training on motor function in a person with hemiparesis: a case report

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, April 8, 2014

Effect of bilateral step-up and -down training on motor function in a person with hemiparesis: a case report

No self-prescribing, you know how dangerous doing anything on your own is.
http://informahealthcare.com/doi/abs/10.3109/09593985.2014.904959

Mansoo Ko, PhD¹, Sean Hilgenberg, PT², Scott M. Hasson, EdD, PT, FACSM, FAPTA³, and Heather J. Braden, PhD, PT, GCS¹

¹Physical Therapy Program, Angelo State University,

San Angelo, TX

, USA,

²Department of Physical Medicine, Shannon Medical Center,

San Angelo, TX

, USA, and

³Department of Physical Therapy, Georgia Regents University,

Augusta, GA

, USA

Address correspondence to

Mansoo Ko, PhD

, Physical Therapy Program, Angelo State University,

San Angelo, TX

, USA. E-mail: mko@angelo.edu

Abstract

Gait training to facilitate the use of the paretic limb for persons with hemiparesis continues to be of interest to those in the clinical research domain. The purpose of this case report was to assess the outcomes of a repeated step-up and -down treatment, initiating with the paretic limb, on functional mobility, endurance and gait kinematic parameters in a person with hemiparesis. The participant was an 85-year-old female 3 years status post left hemiparesis, who reported overall good health. The participant was asked to step up on a 1-inch height wood box with her paretic limb. Once both feet were on top of the box, the participant initiated descent also with her paretic limb. The height of the box gradually progressed to 5 inches based on the participant’s performance and tolerance. A metronome was used to facilitate rhythmic lower extremity movement patterns. The training duration for each treatment session was 7–15 min/day. The participant completed nine sessions spanning over 3 weeks. The outcome measure used to identify motor recovery was the Fugl-Myer (lower extremity). In addition, the timed up and go (TUG), the 6-min walk test (6 MWT) and gait kinematics were assessed to examine mobility and gait. The Fugl-Myer score and 6 MWT did not reflect a meaningful change (0% and +2.6%, respectively). However, TUG scores did show a meaningful change (+31.9%). With respect to gait kinematics, hip flexion on the paretic limb was improved from 11° to 18°, which indicates the normal range of hip motion during the initial swing phase in post-test.