Considerations for the Patient with Neurological Dysfunctions

• Mild to moderate motor impairments following stroke can have significant implications for locomotion
• 40% are limited to ambulating household distances
• approximately 70% experience a fall within the first 6 months following stroke
• patients post-stroke are ten times more likely to sustain a hip fracture
• participation in social activities is directely correlated to independence with community-level ambulation

Therapeutic exercises to improve or increase gait may include manual techniques and assistive devices to increase sensorimotor integration and proprioceptions. Examples of techniques include

• custom AFO or KFO for proprioceptive feedback and stability during weight bearing
• theraband straps to involved LE for increased proprioception and facilitated stepping
• visual cues (mirrors, colored tape on floor, colored signs in hallways) for visual feedback on midline orientation, accuracy, and to practice visual scanning while walking
• metronome or other audio cue (e.g., music) to increase cadence or ability to initiate stepping
• ankle and wrist cuff weights to decrease ataxia from cerebellar lesions
• partial weight-bearing supported gait activities on a treadmill
• hippotherapy (horse-assisted interventions)

 

 Technology-enhanced advancements

Virtual reality, game-based immersion simulation, and exoskeleton technologies are developing and are progressively introduced into rehabilitation settings

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