Post-stroke gait material

[spekis]

Hello!
I'm a 4th year PT student and during our practice I have to work with patients recovering from a stroke a lot. The thing that bugs me is the latter stages of recovery, mostly concerning patient's walking abilities. I was wondering if you could recommend some good, practical materials on the subject? Right now I'm using the book "Neurologic interventions for physical therapy" which does have quite a lot of information on the stroke recovery but, again, no specific exercises, equipment etc. to improve walking. There's so much information out there about, for example, the back pain treatment, how come there are so few practical advices on this huge subject. How do you deal with the latter stages of recovery yourselves?

Thank you very much indeed

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[physiobob]

I would read information on the Motor Relearning program and other such work from Janet Carr and Roberta Shepherd in Australia. Whilst other techniques such as bobath might give a potential for a more normal return to function MRP can provide a functional result in a much shorter time with limited resources. Perhaps comparing approaches in light of quality of movement vs. cost to the healthcare system might be interesting. There are also various unweighted treadmill studies as well that might be worth reviewing.

[mcasus]

You might try some inspiration in the Chedoke-McMaster Stroke Evaluation book. Many of the "tests" can be used as functional rehab exercises.

[spekis]

Thank you for the replies! I will check all of those.

[violablue]

Check out the muscle stim studies, as well. They've found good results even in the timeframe post-stroke where traditionally it wasn't thought further improvements could occur. Unfortunately, the stim walking devices can be quite pricey.

[jbptcal]

Hi Spekis,

You may want to research on evidenced-based materials by reading printed journals online, aside from the other suggested reading materials that were earlier posted. Wishing you well.

jbptcal

[neurocardio]

Hello!
I'm a 4th year PT student and during our practice I have to work with patients recovering from a stroke a lot. The thing that bugs me is the latter stages of recovery, mostly concerning patient's walking abilities. I was wondering if you could recommend some good, practical materials on the subject? Right now I'm using the book "Neurologic interventions for physical therapy" which does have quite a lot of information on the stroke recovery but, again, no specific exercises, equipment etc. to improve walking. There's so much information out there about, for example, the back pain treatment, how come there are so few practical advices on this huge subject. How do you deal with the latter stages of recovery yourselves?

Thank you very much indeed

Hi,
Stroke topic is well explained in Physical Rehabilitation by Susan O'Sullivan and Thomas Schmitz,fifth edition. Gait and walking abilities affected by so many factors like joint integrity and mobility, sensory integrity, perception, voluntary movement control and patterns, strength,posture control and balance, spasticity.......so work on all the causes. NEMS and Orthotics also have been proved very useful to enhance functional training activities in later stages of rehab. Weight bearing mat activities are good in later stages of recovery. Lot can be done for stroke patients , these are just basic things .....So,Spekis,read this chapter 18 from book and I am sure that after that you will able to treat your patient confidently.

[spekis]

Thanks again for all the effort. Much appreciated!