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Obstacle training programme for individuals post stroke: feasibility study

Columbia University, Program in Physical Therapy, New York

Catherine Dean

The University of Sydney, School of Physiotherapy, New York, USA

Bernadette Boden-Albala

Columbia University, College of Physicians & Surgeons, Department of Neurology, School of Public Health, Division of Socio-Medical Science, New York, USA

Ralph Sacco

Columbia University, College of Physicians & Surgeons, Department of Neurology, Sergievsky Center, School of Public Health, Division of Epidemiology, New York, USA

Objective: The purposes were threefold: to develop an obstacle ambulation training programme, to recruit and retain individuals post chronic stroke and to assess the effectiveness of the obstacle ambulation training programme.

Design: Intervention study; case series; baseline to post-intervention measures and one month follow-up after intervention.

Setting: An outpatient department.

Subjects: Five individuals with chronic stroke with mild to moderate functional limitations; convenience sample.

Interventions: Therapy consisted of twice weekly sessions for four weeks during which subjects walked along a walkway and over obstacles.

Main outcome measures: Motor Assessment Scale – walking section (MAS – time), Six-minute Walk Test distance, walking velocity, and Medical Outcomes Study-36 Health Status Measurement (SF-36).

Results: Significant improvements were seen baseline to post intervention for walking velocity, Six-minute Walk Test, MAS and SF-36 physical function score (p £ 0.025 for all measures). Most improvements noted at the end of training were retained one month later. The effect sizes ranged from 0.33 to 1.20.

Conclusions: Substantial improvement in ambulation function and disability level were seen as a result of the obstacle training programme for individuals with chronic stroke. Further investigation is warranted.

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