Rehabilitation

Effects of an 8-week cadence gait training program on knee loading in individuals following ACL reconstruction

While normalization of gait is a primary goal of early rehabilitation, between limb asymmetries in knee extensor moment can persist 6-24 months later and previous literature assessing gait interventions is limited. The purpose of this study was to assess the influence of subject-specific cadence gait training program on knee loading mechanics following ACLr. Nine individuals completed an 8-week cadence training program (20min, 3x/week; Table1) and nine sex- and surgery-matched individuals served as controls. All eighteen participants received standard physical therapy and were tested at 1 and 3 months post-op. Kinematic and kinetic data were collected during walking at a self-selected speed. Repeated measures ANOVAs were used for comparisons; significance α≤0.05. Main effects of limb and time were observed: knee ROM (kROM;p<0.001;p=0.044;Fig.1) and knee extensor moment (kEXT;p=0.003;p=0.002) in the cadence and control groups, respectively. No main effects of group for kROM (p=0.136) or kEXT (p=0.229) were found. A trend toward a significant group x time x limb interaction was observed in kEXT (p=0.092), but not kROM (p=0.412). Post-hoc analyses of kEXT (Fig.2) revealed a significant time x limb interaction for the cadence group (p=0.053) but not the control group (p=0.884). In the cadence group, the time x limb interaction was driven by a 131% increase in kEXT in the surgical limb versus a 42% increase in the non-surgical limb between T1 and T2. Consistent with previous findings, these pilot data show promising results as the cadence intervention resulted in improvements in sagittal plane knee loading compared to controls.


Listed In: Biomechanics, Gait, Orthopedic Research, Physical Therapy, Sports Science


Auditory Cues on Postural Control in Parkinson&#039;s Disease: A Pilot Study

Objective: To evaluate the effect of auditory cues toward postural control in patients with Parkinson's disease (PD). Background: Auditory cues have been proved to be one of rehabilitation strategies for PD [1]. Most of Parkinson's Disease patients present postural instabilities regarding the severity of the disease [2, 3]. Rhythmic Auditory Stimulation (RAS) has been justified to be a standardized neurological motor therapy (NMTs) in PD, which cue-ing benefits may be associated with the activation of cerebellum-thalamic-cortical circuitry [4]. A potential method to stimulate the putamen that might help regulate PD brain's circuits could be providing music as a rhythmical cue [4]. A distinct manifestation in PD is also the arm swing reduction [5] which limits the capability of maintaining balance. It is rare to explore the static standing balance in Parkinson's Disease. Methods: 5 idiopathic PD patients (5 female) aged 72.6 ± 2.51 years, duration of the disease 15 ± 1.22 years (mean ± SD), H&Y 2.5-3 participated in this study. They were recruited from Yawata Medical Center, Ishikawa, Japan in June and November, 2014. The subjects were instructed to stand on the balance platform (Nintendo Wii Fit) and swing arm; Alternation (Alt) and Synchronization (Syn) in 3 scenarios; with no auditory cues (AC), with AC 5% increased and with AC 5 % decreased. The data were analyzed by Wilcoxon Signed Ranks Test and the dimensional clustering method [6] on MATLAB. Results: Tempo at 95% improved area, RMS and Min ML in Alternation, and decreased the path length in rest 2. Tempo at 105% decreased area and RMS in rest 2 statistically significant. A case with H&Y stage 3 showed poorer postural control in both Antero-Posterior (AP) and Medio-Lateral (ML) directions. Most cases presented the higher Center of Pressure (CoP) displacement in ML direction. AC with arm swing regulated the pattern of CoP trajectories. Conclusions: Auditory cues with arm swing - Alternation improved postural control in the PD patients. This concept might be considered clinically to be a rehabilitation program for Parkinson's disease (PD) to improve standing balance. It is a need to enlarge the sample size and develop more rehabilitation programs for improving balance in PD.
Listed In: Physical Therapy, Posturography