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

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@article{a524e12a4d774656bfb492bdb10d5f5b,
title = "Feasibility and Preliminary Efficacy of Visual Cue Training to Improve Adaptability of Walking after Stroke: Multi-Centre, Single-Blind Randomised Control Pilot Trial",
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.",
author = "Hollands, {Kristen L} and Pelton, {Trudy A} and Andrew Wimperis and Diane Whitham and Wei Tan and Sue Jowett and Sackley, {Catherine M} and Wing, {Alan M} and Tyson, {Sarah F} and Jonathan Mathias and Marianne Hensman and {van Vliet}, {Paulette M}",
year = "2015",
month = oct,
day = "7",
doi = "10.1371/journal.pone.0139261",
language = "English",
journal = "PLoSONE",
issn = "1932-6203",
publisher = "Public Library of Science (PLOS)",

}

RIS

TY - JOUR

T1 - Feasibility and Preliminary Efficacy of Visual Cue Training to Improve Adaptability of Walking after Stroke

T2 - Multi-Centre, Single-Blind Randomised Control Pilot Trial

AU - Hollands, Kristen L

AU - Pelton, Trudy A

AU - Wimperis, Andrew

AU - Whitham, Diane

AU - Tan, Wei

AU - Jowett, Sue

AU - Sackley, Catherine M

AU - Wing, Alan M

AU - Tyson, Sarah F

AU - Mathias, Jonathan

AU - Hensman, Marianne

AU - van Vliet, Paulette M

PY - 2015/10/7

Y1 - 2015/10/7

N2 - 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.

AB - 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.

U2 - 10.1371/journal.pone.0139261

DO - 10.1371/journal.pone.0139261

M3 - Article

C2 - 26445137

JO - PLoSONE

JF - PLoSONE

SN - 1932-6203

M1 - e0139261

ER -