Effects of overloading of the lower hemiparetic extremity on walking speedin chronic stroke patients: A pilot study

The objective of this pilot study was to investigate the carryover effects on comfortable walking speed after overloading the lower hemiparetic extrem ity in chronic stroke patients. A single subject research study was conducted using a withdrawal design (A- B-A-B-A) on three patients with ischaemic middle cerebral artery infarction . Chronic stroke patients were recruited with stage 3 or 4 Fugl-Meyer score s in the lower extremity and the ability to ambulate independently without walking aids. Based on this withdrawal design, the daily procedure included walking at comfortable speeds 5 x 10 meters during the Al phase and 3 x 10 meters during all subsequent phases. This procedure was repeated for five consecutive days. Two Ibs (B-1) and 6 Ibs (B-2) weight cuffs Were attached to the distal lower hemiparetic extremity and randomized over the two B pha ses. Control (A(1),A(2), A(3)) and intervention (B-1, B-2) phases were alte rnated With brief resting periods. Mean comfortable walking speed For 10 me ters constituted the outcome variable. All patients showed significant differences between phases (chi(2) = 34.187 ; p < 0.001). However, with the exception of a carry-over effect between th e A(1) (0.86 m/sec) and A(2) (0.89 m/sec) phases in one subject (p = 0.043) no significant carry-over effects were found on ensuing A(2) and A(3) cont rol phases. Although gradual improvements in comfortable walking speed between subseque nt days were found the present pilot study did not demonstrate favorable gr oup effects on comfortable walking speed as a result of limb overloading.