TY - JOUR
T1 - Feasibility of intensive mobility training to improve gait, balance, and mobility in persons with chronic neurological conditions
T2 - A case series
AU - Fritz, Stacy
AU - Merlo-Rains, Angela
AU - Rivers, Erin
AU - Brandenburg, Barbara
AU - Sweet, Janea
AU - Donley, Jonathan
AU - Mathews, Harvey
AU - Debode, Stella
AU - McClenaghan, Bruce A.
PY - 2011/9
Y1 - 2011/9
N2 - Background and Purpose: Intensive mobility training (IMT) is a rehabilitative approach aimed at improving gait, balance, and mobility through the incorporation of task-specific, massed practice. The purpose of this case series was to examine the feasibility and benefits of the IMT protocol across a sample of 4 individuals with diverse chronic neurological diagnoses, including incomplete spinal cord injury, Parkinson'S disease, stroke, and cerebral hemispherectomy. Methods: The 4 participants enrolled in the IMT protocol and followed an intensive treatment schedule of 3 h/d sessions for 10 consecutive weekdays totaling 30 hours. Each session allocated 1 hour each to (1) body weight-supported treadmill-based locomotor training, (2) balance interventions, and (3) activities to improve coordination, strength, and range of motion. Interventions emphasized repetitive, task-specific training of lower-extremity movements in a massed practice schedule. Pain, fatigue, and time in activity were used to assess feasibility of the treatment. Temporal-spatial gait parameters, Berg Balance Scale, Dynamic Gait Index, Timed Up and Go test, and 6-Minute Walk test were used to assess changes in performance. Results: Participants were able to complete an average of 144 of 180 minutes of activity per day for 10 days. Participants demonstrated modest improvements after the intervention on at least one outcome measure for each target area of gait, mobility, and balance. Some improvements were maintained for 1 to 6 months after participation. Discussion: Despite differences in diagnosis among these participants with chronic neurological disorders, on average they were able to complete 80% of an intensive treatment schedule of 3 hours/day for 10 days with no adverse effects. It appears that some gains made during participation are maintained for a period of time after the end of training. IMT is a feasible intervention incorporating an intensive training approach to improve gait, balance, and mobility; however, a randomized trial is needed to further investigate the effects of the intervention.
AB - Background and Purpose: Intensive mobility training (IMT) is a rehabilitative approach aimed at improving gait, balance, and mobility through the incorporation of task-specific, massed practice. The purpose of this case series was to examine the feasibility and benefits of the IMT protocol across a sample of 4 individuals with diverse chronic neurological diagnoses, including incomplete spinal cord injury, Parkinson'S disease, stroke, and cerebral hemispherectomy. Methods: The 4 participants enrolled in the IMT protocol and followed an intensive treatment schedule of 3 h/d sessions for 10 consecutive weekdays totaling 30 hours. Each session allocated 1 hour each to (1) body weight-supported treadmill-based locomotor training, (2) balance interventions, and (3) activities to improve coordination, strength, and range of motion. Interventions emphasized repetitive, task-specific training of lower-extremity movements in a massed practice schedule. Pain, fatigue, and time in activity were used to assess feasibility of the treatment. Temporal-spatial gait parameters, Berg Balance Scale, Dynamic Gait Index, Timed Up and Go test, and 6-Minute Walk test were used to assess changes in performance. Results: Participants were able to complete an average of 144 of 180 minutes of activity per day for 10 days. Participants demonstrated modest improvements after the intervention on at least one outcome measure for each target area of gait, mobility, and balance. Some improvements were maintained for 1 to 6 months after participation. Discussion: Despite differences in diagnosis among these participants with chronic neurological disorders, on average they were able to complete 80% of an intensive treatment schedule of 3 hours/day for 10 days with no adverse effects. It appears that some gains made during participation are maintained for a period of time after the end of training. IMT is a feasible intervention incorporating an intensive training approach to improve gait, balance, and mobility; however, a randomized trial is needed to further investigate the effects of the intervention.
KW - Parkinson's disease
KW - cerebral hemispherectomy
KW - incomplete spinal cord injury
KW - intensive therapy
KW - locomotor training
KW - massed practice
KW - stroke
KW - task-specific practice
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UR - http://www.scopus.com/inward/citedby.url?scp=80052459017&partnerID=8YFLogxK
U2 - 10.1097/NPT.0b013e31822a2a09
DO - 10.1097/NPT.0b013e31822a2a09
M3 - Article
C2 - 21934376
AN - SCOPUS:80052459017
SN - 1557-0576
VL - 35
SP - 141
EP - 147
JO - Journal of Neurologic Physical Therapy
JF - Journal of Neurologic Physical Therapy
IS - 3
ER -