Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2021; 9(3): 632-638
Published online Jan 26, 2021. doi: 10.12998/wjcc.v9.i3.632
Dynamic biomechanical effect of lower body positive pressure treadmill training for hemiplegic gait rehabilitation after stroke: A case report
Hui-Fang Tang, Bing Yang, Qiang Lin, Jun-Jie Liang, Zhi-Wei Mou
Hui-Fang Tang, Zhi-Wei Mou, Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou 510630, Guangdong Province, China
Bing Yang, Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, Guangdong Province, China
Qiang Lin, Jun-Jie Liang, Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou 510070, Guangdong Province, China
Author contributions: Tang HF reviewed the literature and contributed to data analysis and manuscript drafting; Yang B interpreted the study findings; Lin Q and Liang JJ were the patient’s rehabilitation physicians and contributed to data collection; Mou ZW drafted the manuscript and was responsible for the revision of the manuscript; all authors issued final approval for the version to be submitted.
Supported by National Natural Science Foundation for Young Scientists of China, No. 81902281; Guangdong Medical Science and Technology Research Foundation of China, No. A2019120 and No. A2020362; and Special Project of Chinese Government for Science and Technology of Guangdong Province, No. 2019SKJ003.
Informed consent statement: The patient provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Nothing to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Wei Mou, MD, PhD, Associate Chief Physician, Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Avenue, Guangzhou 510630, Guangdong Province, China. mouzhiwei@jnu.edu.cn
Received: July 21, 2020
Peer-review started: July 21, 2020
First decision: November 3, 2020
Revised: November 18, 2020
Accepted: November 29, 2020
Article in press: November 29, 2020
Published online: January 26, 2021
Processing time: 181 Days and 21.1 Hours
Abstract
BACKGROUND

Lower body positive pressure (LBPP) treadmill has potential applications for improving the gait of patients after stroke, but the related mechanism remains unclear.

CASE SUMMARY

A 62-year-old male patient suffered from ischemic stroke with hemiplegic gait. He was referred to our hospital because of a complaint of left limb weakness for 2 years. The LBPP training was performed one session per day and six times per week for 2 wk. The dynamic plantar pressure analysis was taken every 2 d. Meanwhile, three-digital gait analysis and synchronous electromyography as well as clinical assessments were taken before and after LBPP intervention and at the 4-wk follow-up. During LBPP training, our patient not only improved his lower limb muscle strength and walking speed, but more importantly, the symmetry index of various biomechanical indicators improved. Moreover, the patient’s planter pressure transferring from the heel area to toe area among the LBPP training process and the symmetry of lower body biomechanical parameters improved.

CONCLUSION

In this study, we documented a dynamic improvement of gait performance in a stroke patient under LBPP training, which included lower limb muscle strength, walking speed, and symmetry of lower limb biomechanics. Our study provides some crucial clues about the potential dynamic mechanism for LBPP training on gait and balance improvement, which is related to rebuilding foot pressure distribution and remodeling symmetry of biomechanics of the lower limb.

Keywords: Lower body positive pressure treadmill; Dynamic plantar pressure; Stroke; Gait analysis; Electromyography; Case report; Rehabilitation

Core Tip: Lower body positive pressure (LBPP) treadmill has potential applications for improving the gait of patients after a stroke, although the related mechanism remains unclear. To the best of our knowledge, our case report is the first study for the dynamic observation on hemiplegic gait rehabilitation using plantar pressure analysis, which presents with every detail of the changes in gait. Meanwhile, we also presented the macroscopic longitudinal changes using the clinical assessments and three-digital gait analysis before and after LBPP intervention and at a follow-up. The critical clues were found for the potential dynamic mechanism for LBPP training on the gait and balance improvement, which is related to rebuilding foot pressure distribution and remodeling symmetry of biomechanics of the lower limb.