Phase Manipulation and Walking in Stroke

Abstract: Purpose: The purpose of this study was to investigate the effects of in- and out-phase arm movement on upper and lower body movement patterns during walking in individuals with stroke. Methods: Eight individuals (ages 14-74 years) who had suffered a cerebrovascular accident and walked independently participated. There were three separate conditions of walking at 0.22, 0.40, and 0.63 m/s: (1) with no upper extremity phase manipulation, (2) instructions to move the arms in-phase at each velocity level, (3) instructions to move the arms out-of-phase at each velocity level. Results: With instruction to the move the arms out-of-phase, the arms moved more reciprocally, back and forth, coinciding with increased arm swing, greater transverse trunk rotation as compared to when subjects were instructed to move the arms in-phase. Instructions to move the arms either in- or out-of-phase led to coordination between arm movement frequency and stride frequency (1:1 frequency coordination). Discussion: Stroke is the leading cause of disability in the United These findings showed that altered arm swing is constrained by an attraction to 1:1 frequency coordination. Arm swing amplitude was not specified; however participants swung their arms at a frequency that synchronized with stride frequency (1:1 coordination). Future study is still needed to examine how paretic arm movement affects intersegmental coordination during walking. Research is needed to assess the effects of imposed upper extremity phasing and whether training with specific phase relations facilitates a relatively permanent change in the intersegmental coordination and therefore walking function in patients who have suffered a stroke. (C) 2007 Neurology Section, APTA To obtain full text: http://www.jnpt.org/pt/re/jnpt/userLogin.htm