Biomedical subjects

Daniel Bourbonnais

Publications and source records attributed to Daniel Bourbonnais.

At least 19 recordsLinked to original sources

PubMed2006

Predictors of long-term participation after stroke.

PURPOSE: (1) To explore factors that predict long-term participation after stroke (2-4 years after discharge from rehabilitation), and (2) to determine factors that predict both short- and long-term participation. METHODS: Biopsychosocial data of people who had had a stroke were measured at discharge from an intensive rehabilitation unit using valid instruments. Six months later (n=102) as well as 2-4 years later (n=66), social participation of the survivors was measured in their living environments. Participation was estimated with the Assessment of Life Habits (LIFE-H), which includes 12 categories of daily activities and social roles. RESULTS: From multivariate regression analyses, the best predictors of long-term participation after stroke appear to be age, comorbidity, motor coordination, upper extremity ability and affect. Age, comorbidity, affect and lower extremity coordination are the best predictors of participation after stroke at both measurement times. CONCLUSIONS: With the exception of age, these factors may be positively modified and thus warrant special attention in rehabilitation interventions.

Activities of Daily Living↗

PubMed2006

Kinematic analysis of upper limbs and trunk movement during bilateral movement after stroke.

OBJECTIVE: To compare the kinematics of the upper limbs and trunk during unilateral and parallel bilateral tasks in subjects with hemiparesis and control subjects. DESIGN: Comparative study. SETTING: Geriatric center offering rehabilitation services. PARTICIPANTS: Convenience sample of 15 persons (age, 69.4 +/- 12.0 y; > or = 3 mo poststroke) recruited in a geriatric center with rehabilitation services, and 13 control persons (67.8 +/- 7.5 y) participated in the study. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Unilateral and bilateral movements toward 1 or 2 targets located beyond arm's length and positioned in 3 directions. Angular changes of both upper limbs and trunk were characterized in the sagittal, frontal, and horizontal planes. RESULTS: During the bilateral task, the deficits of the kinematic joints of the paretic upper limb persisted in subjects with hemiparesis as compared with the corresponding upper limb in the control subjects (abduction shoulder: subjects with hemiparesis, 5.7 degrees +/- 5.3 degrees; control subjects, 0.7 degrees +/- 4.8 degrees; extension elbow: subjects with hemiparesis, 38.2 degrees +/- 14.2 degrees; control subjects, 52.8 degrees +/- 12.5 degrees) with a marked flexion of the trunk (subjects with hemiparesis, 33.7 degrees +/- 8.7 degrees; control subjects, 26.8 degrees +/- 5.8 degrees). The elbow extension of the nonparetic upper limb was reduced (subjects with hemiparesis, 41.0 degrees +/- 13.6 degrees; control subjects, 52.8 degrees +/- 12.5 degrees). CONCLUSIONS: The use of parallel bilateral reaching tasks and placing movements of the upper extremities in the subjects with hemiparesis contributed an increase in the trunk flexion rather than improve the motor performance of the paretic upper limb, especially with regard to increasing elbow extension.

Aged↗

PubMed2006

Long-term changes in participation after stroke.

BACKGROUND AND PURPOSE: People who have had a stroke may have difficulty resuming some of their previous activities, which leads to a decline in their participation in daily activities and social roles. The purposes of this study were to compare participation 6 months (T1) and between 2 and 4 years (T2) after discharge from a rehabilitation unit and to verify if any changes were associated with changes in personal and environmental factors. METHOD: Participation of people who had had a stroke was measured at T1 and T2 with the Assessment of Life Habits. RESULTS: A significant reduction (p < .001) in participation in daily activities was observed, specifically in the following categories: nutrition, p < .001; fitness, p = .004; personal care, p < .001; and housing, p = .001. However, participation in social roles was maintained during this period (p = .10). The increased perception of technology as a facilitator (environmental factor) over time explained a part of the decline in participation (R2 = 0.13). CONCLUSION: Factors associated with the reduction in participation in daily activities should be further studied in order to prevent this decline.

Activities of Daily Living↗

PubMed2005

Norms for 15- to 34-year-olds for different versions of the finger-to-nose test.

OBJECTIVES: To develop norms for the time to execute different versions of the finger-to-nose test (FNT) and to determine the effects of different testing procedures on performance in people aged 15 to 34 years. DESIGN: Cross-sectional. SETTING: Research center. PARTICIPANTS: Healthy subjects (149 men, 148 women; age range, 15-34 y) participated, and 36 men and 36 women were included in each of the 4 age categories studied (15-19 y, 20-24 y, 25-29 y, 30-34 y). Participants performed, in random order, 5 forms of the test in 2 positions (sitting, supine) with the right and left upper limbs (ULs). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Time (in seconds) to complete 5 cycles of movement. RESULTS: Test version and side of UL were found to affect performances; right-sided performances were faster than left-sided. Performances did not vary significantly (P>.001) with sex or among age categories; therefore, the results are presented for the group. Mean performances varied from 3.44 to 4.29 seconds. Subsequent analysis of variance (with data for each UL) showed main effects for testing position (sitting > lying) and eye condition (eyes open > eyes closed). Versions were strongly interrelated (.85<r<.98). CONCLUSIONS: Norms for the time to execute different FNT versions were developed for both ULs for healthy people ages 15 to 34 years.

Adolescent↗

PubMed2005

Handwriting performance in preterm children compared with term peers at age 6 to 7 years.

Preterm infants are at high risk for developmental impairments at school age. However, the impact of these impairments on important life skills, such as handwriting, is unknown. Forty-eight first-grade children (27 males, 21 females; mean age 6y 7mo, SD 3.9mo; range 6y 1mo to 7y 3mo) born preterm (birthweight < 1250g; gestational age < 34wks), without major physical or cognitive disabilities, were matched to 69 healthy, term control children (32 males, 37 females; mean age 6y 10mo, SD 3.6mo; range 6y 3mo to 7y 4mo) by sex and school class. All children were assessed using the Evaluation Tool of Children's Handwriting-Manuscript and several sensorimotor measures. Preterm children demonstrated significantly lower legibility and slower speed scores (p < 0.01) compared with control children for most of the handwriting tasks. Factors associated with legibility were visual perception and eye-hand coordination (r < 0.50; p < 0.05) and sex (r < 0.12; p = 0.01). In-hand manipulation and finger identification (r < 0.43; p < 0.01) were significantly correlated with slow handwriting speeds. Behaviour difficulties associated with hyperactivity and poor attention (Connors Abbreviated Symptoms Questionnaire) had a confounding influence on both legibility and speed. These findings may help guide early identification efforts and medical/therapeutic interventions for preterm children.

Attention↗

PubMed2005

Weight-bearing on the lower limbs in a sitting position during bilateral movement of the upper limbs in post-stroke hemiparetic subjects.

OBJECTIVE: Verify weight-bearing on the feet in a sitting position during pointing in different directions with 1 or both upper limbs. DESIGN: Comparative study. SUBJECTS: Fifteen subjects with post-stroke hemiparesis with good to very good motor recovery and 13 healthy subjects participated in the study. METHODS: The subjects were seated on a chair with each foot resting on a force plate. They had to touch with 1 or, simultaneously with both hands, 2 target(s) located in front of them or at a 45 degrees angle on either side at a standardized distance beyond their upper limb's length. The percentage of weight loading variation under each foot was measured. RESULTS: Weight-bearing on the paretic foot is reduced during unilateral and bilateral pointing in the anterior direction and 45 degrees ipsilateral to the paretic side. However, both unilateral and bilateral pointing 45 degrees contralateral to the paretic side produced symmetrical weight-bearing on both feet, paretic and non-paretic. CONCLUSION: Since the paretic muscles of the trunk are probably used to control the leaning of the trunk towards the non-paretic side, the subjects with hemiparesis may put weight on the paretic foot to compensate for trunk weakness and maintain balance.

Aged↗

PubMed2005

Participation after stroke compared to normal aging.

OBJECTIVE: To examine the reduction in participation of people who have had a stroke compared with healthy people with normal aging. DESIGN: Participation of people who had a stroke was compared with participation of healthy subjects. SUBJECTS/PATIENTS: Forty-six people who had a stroke for 2-4 years and 46 healthy participants matched on age, sex and living environment. MEASUREMENTS: Participation was estimated with the Assessment of Life Habits (LIFE-H). The LIFE-H (short version 2.1) is composed of 58 daily activities and social roles associated to the 12 categories of the Disability Creation Process model. The LIFE-H gives separate scores for each category, for 2 main subsections "Daily activities" and "Social roles" and a total score. RESULTS: Scores of healthy subjects did not reach the maximum value (9/9) of the LIFE-H, their mean scores varying from 6.3 to 8.6, according to the categories. These scores are higher than of the participants with stroke for all categories (scores varying from 3.9 to 6.5; p-values from 0.002 to <0.001), except the interpersonal relationships category (score of 7.8 vs 8.0) where no difference was found (p=0.49). The disruption in participation after stroke varies according to the categories of the LIFE-H, but is more important in the daily activities categories. CONCLUSION: The comparison of the scores obtained by the 2 groups suggests that a part of the reduction in participation in daily activities and social roles after stroke is attributable to normal aging and not entirely to the stroke itself. It helps to focus interventions on activities and roles disruption domains that are really attributable to stroke.

Activities of Daily Living↗

PubMed2005

Effectiveness of unilateral and symmetrical bilateral task training for arm during the subacute phase after stroke: a randomized controlled trial.

OBJECTIVE: To evaluate the effect of an arm training programme combining repetition of unilateral and symmetrical bilateral tasks for people in the subacute phase after stroke. DESIGN: Randomized controlled trial. SETTING: Inpatient functional rehabilitation unit. SUBJECTS: Forty-one people who had had a stroke, in the subacute phase, receiving conventional arm occupational and physical therapy, were randomized to an experimental group (n=20) and a control group (n=21). INTERVENTIONS: In addition to the usual arm therapy in the rehabilitation unit, the experimental group received an arm therapy programme (15-20 45-min sessions) based on repetition of unilateral and symmetrical bilateral tasks. The control group received additional usual arm therapy of a similar duration and frequency to the experimental treatment. MAIN MEASURES: The effect of the programme was judged on the basis of: (1) arm impairments (motor function, grip strength, gross and fine manual dexterity and motor co-ordination), (2) arm disabilities in tasks related to daily activities, and (3) functional independence in activities of daily living (ADL) and instrumental ADL (IADL). RESULTS: Although both experimental and control groups of participants improved similarly during the study period, the statistical analyses did not show any difference between the groups at the end of the treatment for the different dependent variables evaluated: (1) arm impairments: p = 0.43-0.79; (2) arm disabilities: p = 0.16-0.90; and (3) functional independence: p = 0.63 and 0.90. CONCLUSIONS: An arm training programme based on repetition of unilateral and symmetrical bilateral practice did not reduce impairment and disabilities nor improve functional outcomes in the subacute phase after stroke more than the usual therapy.

Activities of Daily Living↗

PubMed2004

Differences in the magnitude and direction of forces during a submaximal matching task in hemiparetic subjects.

Stroke patients often exhibit large imbalances in strength between the two upper limbs (ULs) and between the different muscle groups of the paretic UL. The aim of the study was to compare the ability of hemiparetic and normal subjects to produce symmetrical forces with both ULs and to determine whether the differences between force vectors can be predicted by a model accounting for the weakness of the different muscle groups or from clinical characteristics. Sixteen hemiparetic and 16 control subjects were assessed using static dynamometers in which both ULs were fixed. They were asked to produce symmetrical sub-maximal forces (in terms of direction and magnitude) with both ULs in four directions in the sagittal plane, which covers all possible combinations of flexion and extension at the shoulder and the elbow. Fifteen trials were performed, and the subjects were asked to gradually increase the forces produced from one trial to another. In addition, the maximal voluntary force (MVF) was measured unilaterally on both sides under two conditions: single-joint MVF (isolated flexion or extension at the elbow or the shoulder) and multi-joint MVF (same directions as the bilateral task). During the bilateral task, the stroke subjects generally showed larger errors between limbs than the control subjects, although they were able to produce sufficient force in the required directions during multi-joint MVF. The difference between groups was statistically significant in the four target directions for the errors in the magnitude, and in two target directions for the errors in direction (p<0.01). Differences predicted by a model based on the relative single-joint MVFs show a moderate association with errors observed for the magnitude (p=0.001-0.11, R2=0.17-0.54), but not for the direction of forces (p>0.1, R2<0.16). Several clinical features were examined as potential predictors using stepwise multiple regressions. The mean multi-joint MVF and proprioceptive impairments were the best predictors of mean errors in the magnitude of force (p<0.001, R2=0.82) whereas the mean angular errors were best explained by proprioceptive impairments (p=0.01, R2=0.38). Inaccurate internal representations of the paretic UL might explain why asymmetries were observed even though motor capacities were sufficient to perform successfully.

Adult↗

PubMed2004

Dynamic analysis of trunk flexion after stroke.

OBJECTIVE: To quantify trunk movement and lower-extremity weight bearing in patients with stroke-associated hemiparesis compared with healthy subjects. DESIGN: Controlled study with 2 groups: persons with hemiparesis and healthy controls. SETTING: Geriatric center offering rehabilitation services. PARTICIPANTS: A convenience sample of 15 persons with poststroke hemiparesis (age, 69.4+/-12.0y; > or =3mo poststroke; total motor function range, 63-95/100) on the Fugl-Meyer Assessment and of 13 healthy persons (age, 67.8+/-7.5y). INTERVENTIONS: Subjects were seated on a chair placed on a forceplate with their feet on 2 additional forceplates. A target was placed directly in front of or at a 45 degrees angle from the midline at 66% of the nonparetic/dominant arm length. Subjects' task was to touch the target with their forehead. Main outcome measures Amplitude and speed of trunk movements, displacement of the global center of pressure (COP), and percentage of body weight distributed on the buttocks and the feet. RESULTS: Despite speed and amplitude comparable to that of the healthy subjects (NS), subjects with hemiparesis (HS) had less COP displacement (HS, 33.7+/-6.9; NS, 40.5+/-9.2), resulting in a lower weight-bearing value on the feet (HS for the paretic foot, 2.3%+/-3.6%; HS for the nonparetic foot, 2.2%+/-2.9%; NS for the nondominant foot, 5.4%+/-3.4%; NS for the dominant foot, 5.2%+/-4.0%). CONCLUSIONS: The similar amplitude of trunk flexion with a decreased displacement of COP and a lower weight bearing on the feet suggest smaller anterior displacement of the body mass. It is possible that trunk movements in persons with hemiparesis are executed by the upper trunk with very little anterior tilt of the pelvis.

Aged↗

PubMed2004

Physiotherapy for persistent postnatal stress urinary incontinence: a randomized controlled trial.

OBJECTIVE: The aim of this study was to compare the effectiveness of multimodal supervised physiotherapy programs with the absence of treatment among women with persistent postnatal stress urinary incontinence. METHODS: This was a single-blind randomized controlled trial. Sixty-four women with stress urinary incontinence were randomly assigned to 8 weeks of either multimodal pelvic floor rehabilitation (n = 21), multimodal pelvic floor rehabilitation with abdominal muscle training (n = 23), or control non-pelvic floor rehabilitation (n = 20). The primary outcome measure consisted of a modified 20-minute pad test. The secondary outcome measures included a Visual Analog Scale describing the perceived burden of incontinence, the Urogenital Distress Inventory, the Incontinence Impact Questionnaire, and pelvic floor muscle function measurements. RESULTS: Two patients dropped out, leaving 62 for analysis. At follow-up, more than 70% of the women in the treatment groups (14/20 in the pelvic floor and 17/23 in the pelvic floor plus abdominal group) were continent on pad testing compared with 0% of women in the control group. Scores on the pad test, Visual Analog Scale, Urogenital Distress Inventory, and Incontinence Impact Questionnaire improved significantly in both treatment groups (all P <.002), whereas no changes were observed in the control group. Pelvic floor muscle function, however, did not improve significantly in either active group. CONCLUSION: Multimodal supervised pelvic floor physiotherapy is an effective treatment for persistent postnatal stress urinary incontinence.

Abdominal Muscles↗

PubMed2004

Relative shoulder flexor and handgrip strength is related to upper limb function after stroke.

OBJECTIVE: To compare the relative strength of different muscle groups of the paretic upper limb and assess the relationship with motor performance. DESIGN: Descriptive study. SETTING: Secondary care rehabilitation centre. SUBJECTS: A convenience sample of 13 chronic hemiparetic stroke subjects. MAIN OUTCOME MEASURES: The maximal active torques of five muscle groups were measured in both upper limbs (UL) and converted into relative strength (paretic/nonparetic). The UL function was assessed using the Box and Block Test, the Finger-to-Nose Test, the Fugl-Meyer Test and the TEMPA (Test Evaluant les Membres supérieurs des Personnes Agées). RESULTS: The Friedman two-way analysis of variance shows a significant difference across the relative strength of the different muscle groups (p = 0.017), but subsequent multiple comparisons indicate a significant difference between handgrip and elbow extension only (relative strength of 0.52 +/- 0.27 and 0.73 +/- 0.23 respectively). However, data show the presence of large intrasubject imbalances between muscle groups. The relative forces for shoulder flexion and handgrip are the best predictors of the UL function, the higher Spearman's rho correlation coefficients for each clinical test ranging from 0.70 to 0.81. CONCLUSIONS: These results do not confirm classical clinical teaching regarding the distribution of weakness following stroke (e.g., proximal to distal gradient; extensors more affected than flexors) but support the hypothesis that strength is related to the function of the paretic upper limb.

Adult↗

PubMed2003

Effects of weakness on symmetrical bilateral grip force exertion in subjects with hemiparesis.

It has been shown that, in a bilateral force-matching task, subjects presenting weakness in one limb produce a lower force in the weakened limb even though they subjectively perceive that they are exerting the same force. The aim of this study was to verify whether subjects with hemiparesis produced asymmetrical forces during a bilateral submaximal grip task and whether this asymmetry is related to weakness of the paretic limb. Fifteen subjects with hemiparesis and 15 healthy subjects were recruited. First, the maximal voluntary force was measured for each hand. Then, subjects were asked to exert equal forces with both hands simultaneously at three submaximal force levels using two dynamometers. In the bilateral task, the force ratios (paretic/nonparetic or nondominant/dominant) differed between groups. Severely weak hemiparetic subjects produced lower force ratios than mildly weak hemiparetic subjects and healthy subjects (P < 0.000), whereas there was no difference between the force ratios produced by mildly weak hemiparetic subjects and those produced by healthy subjects. In subjects with hemiparesis, the force ratios in the bilateral task were related to the ratios of maximal voluntary forces (R2 = 0.39-0.66, P < or = 0.013) and the presence of somatosensory impairment did not affect these relationships. These results suggest that the strategy used is to compare the intensity of the motor commands on both sides and then perform the force-matching task. The use of such a strategy by subjects who have had paresis for 1 year reflects a lack of adaptation to their weakness.

Adult↗

PubMed2003

Head and trunk stabilization strategies during forward and backward walking in healthy adults.

The purpose of this study was to investigate the head and trunk equilibrium strategies while walking forwards and backwards under different conditions (eyes open vs. closed, hard vs. soft surface) in a sample of 11 consenting healthy adult subjects. Nine markers placed on the subject allowed us to record the kinematics of the head, spine and pelvis segments while walking. The data were acquired and analyzed using an optical TV-image processor (ELITE system). For each locomotor trial, the walking speed as well as the absolute angular dispersions and the anchoring indexes (AI) of six segments around the roll and pitch axes were calculated to assess the head and trunk equilibrium strategies. A three-way repeated measures analysis of variance was used to depict differences between the walking conditions. The results showed that the walking speed was affected by the locomotion tasks (P < 0.05) with values ranging from 1.10 +/- 0.21 m s(-1) for natural conditions (walking forwards on a hard surface, eyes open) to 0.79 +/- 0.15 m s(-1) for the most unusual conditions (walking backwards on a foam support, eyes closed). In general, walking backwards reduced the angular dispersion of the spine segments while the absolute angular dispersions of the head and pelvis did not vary significantly with any factors (P > 0.05). The AI around the roll axis indicated good stabilization in space of the head and pelvis with high positive values and this stability increased while the subject was walking backwards on a soft surface (foam). By contrast, the spinal segments were predominantly stabilized on the underlying segment (negative AI), and this stabilization even increased when the subjects walked backwards on a soft surface. Increasing the locomotion difficulty thus induced a generally rigid ('en bloc') functioning of the spinal segments and increased effectiveness of the head and pelvis stabilization strategies in space, especially when walking backwards on a soft surface.

Adult↗

PubMed2003

Associations between lower limb impairments, locomotor capacities and kinematic variables in the frontal plane during walking in adults with chronic stroke.

OBJECTIVE: The objective was to examine the associations between impairments of the paretic limb, locomotor capacities and kinematic variables in the frontal plane during walking. DESIGN: Cross-sectional study. SUBJECTS: Ten community-dwelling individuals with chronic hemiparesis due to a cerebrovascular accident. METHODS: Frontal plane kinematics of the shoulders and pelvis were assessed during treadmill walking in a gait lab using a videographic system to obtain the lateral displacements and lateral accelerations. The percentages of time spent in single stance were determined with foot-switches. Index of asymmetry for the lateral accelerations and single stance were also calculated. Subject motor and functional characteristics were measured by standardised clinical tests. RESULTS: Correlation analyses with Pearson product-moment correlation or Spearman's rank correlation revealed that, except for spasticity, the clinical scores were moderately to strongly associated with frontal kinematics and the single stance. In the multiple step-wise regression analysis, only the pelvic lateral displacements and the index of asymmetry in single stance were explained at more than 70% by the clinical scores with the Time Up and Go test explaining a high proportion of the total variance of these frontal parameters. CONCLUSION: Findings demonstrated associations between physical impairments, locomotor capacities and the frontal kinematics in adults with chronic stroke.

Adult↗

PubMed2003

Comparison of changes in upper and lower extremity impairments and disabilities after stroke.

The aims of this study were to determine if the changes in impairment and disability measures for the upper and lower extremities were equivalent during the post-stroke rehabilitation period and whether the rates of change were maintained 6 months after discharge from rehabilitation. A prospective cohort study design was used. One-hundred-and-thirty-two people who had sustained a stroke and who were enrolled in an intensive functional rehabilitation programme were recruited. Upper and lower extremity impairments and disabilities were evaluated at admission, at discharge from rehabilitation and 6 months later. During active rehabilitation, the changes in both extremities were smaller for the impairment measures (standardized response mean (SRM), 0.37-0.63) than the disability measures (SRM, 0.76-1.05). While the changes in upper and lower extremities were equivalent for impairment measures, they were larger in the lower extremity for disability measures, indicating that the rate of functional improvement was faster in the lower extremity during active rehabilitation. After discharge, however, while the rate of motor recovery in the lower extremity dropped (SRM, 0.54-0.18), it was maintained in the upper extremity (SRM, 0.45 and 0.42). Present findings indicate that functional (disability) measures improve faster than impairment measures in both extremities during the active rehabilitation period and suggest that motor recovery occurs at a different rate in the upper and lower extremities, with that of the upper extremity occurring later and extending into the period after discharge from active rehabilitation.

Aged↗

PubMed2003

Arm and leg impairments and disabilities after stroke rehabilitation: relation to handicap.

OBJECTIVES: (1) To examine the relationships between measures of impairment and disability for the arm and leg with a measure of handicap and (2) to identify the impairment or disability most strongly related to handicap situations. DESIGN: Prospective cohort study. SETTING: Intensive functional rehabilitation unit and community. PATIENTS: One hundred and two persons who had a stroke. MAIN OUTCOME MEASURES: Arm and leg impairments and disabilities were evaluated with reliable and valid tests at discharge from rehabilitation. Six months later, handicap situations were evaluated with the Assessments of Life Habits (LIFE-H). RESULTS: Arm and leg impairments and disabilities are correlated with handicap situations. Disability of the leg is more strongly associated with handicap than arm disability. Arm and leg disabilities are not statistically more strongly related to handicap than arm and leg impairments. CONCLUSIONS: The high correlations found between handicap situations and the impairment and disability measures of the leg provide new information that support the importance of mobility to promote integration after stroke.

Aged↗

PubMed2002

Effect of force-feedback treatments in patients with chronic motor deficits after a stroke.

OBJECTIVE: To assess the effects a motor reeducation approach based on static dynamometers used to provide feedback on the force produced. DESIGN: The study design was a single-blind, randomized, controlled trial. Chronic stroke subjects participated in a 6-wk, thrice-weekly, force-feedback program of either the upper paretic limb (n = 13) or the lower paretic limb (n = 12). Baseline and postintervention assessments of the performance of both the upper and the lower limb were measured for each subject, the untreated paretic limb of each group serving as a control for the other group. RESULTS: With the exception of the handgrip force, strength measurements of the treated limb increased after completion of the treatment. The outcome measurements of the upper limb of the subjects included in the upper paretic limb were not significantly different after treatment from those measured in the lower paretic limb. In contrast, gait velocity and the distance walked in 2 min increased after treatment in the lower paretic limb as compared with the upper paretic limb, whereas the scores in the Fugl-Meyer test for the lower limb and the timed up-and-go test did not increase for either group after treatment. CONCLUSION: The results indicate that treatment of the lower limb based on force feedback produces an improvement of gait velocity.

Adult↗