Course Description:

Seventy-five percent of individuals who have a stroke experience some limitations related to walking. Sensorimotor impairments caused by infarct or hemorrhage within the brain can result in unilateral paresis, abnormal muscle tone and motor control, and poor coordination, any of which can contribute to an abnormal gait pattern and functional limitations. Poststroke gait is characterized by asymmetry, compensatory strategies such as hip hiking and circumduction, reduced stride and step length, decreased walking speed and endurance, and impaired balance. Limitations in walking ability limit participation in activities and increase risk of secondary complications such as falls, so walking is usually identified by poststroke patients as a primary concern. Conventional gait training strategies include overground gait training, task-oriented training, muscle strengthening, treadmill training, functional electrical stimulation (FES), and balance training. Multimodal gait training is commonly used, although few studies have evaluated the effectiveness of combining interventions. Assistive and adaptive devices such as walkers, canes, and orthoses can be prescribed to address impairments in balance and lower extremity motor control. Newer technologies that are beginning to become clinically available include body weight supported treadmill training (BWSTT) and electromechanical or robotic-assisted gait training.