Effects of periodic robot rehabilitation using the Hybrid Assistive Limb for a year on gait function in chronic stroke patients

Using a robot for gait training in stroke patients has attracted attention for the last several decades. Previous studies reported positive effects of robot rehabilitation on gait function in the short term. However, the long-term effects of robot rehabilitation for stroke patients are still unclear. The purpose of the present study was to investigate the long-term effects of periodic gait training using the Hybrid Assistive Limb (HAL) on gait function in chronic stroke patients. Seven chronic stroke patients performed 8 gait training sessions using the HAL 3 times every few months. The maximal 10-m walk test and the 2-minute walking distance (2MWD) were measured before the first intervention and after the first, second, and third interventions. Gait speed, stride length, and cadence were calculated from the 10-m walk test. Repeated one-way analysis of variance showed a significant main effect on evaluation time of gait speed (F = 7.69, p < 0.01), 2MWD (F = 7.52, p < 0.01), stride length (F = 5.24, p < 0.01), and cadence (F = 8.43, p < 0.01). The effect sizes after the first, second, and third interventions compared to pre-intervention in gait speed (d = 0.39, 0.52, and 0.59) and 2MWD (d = 0.35, 0.46, and 0.57) showed a gradual improvement of gait function at every intervention. The results of the present study showed that gait function of chronic stroke patients improved over a year with periodic gait training using the HAL every few months.     

A follow-up study of the effect of training using the Hybrid Assistive Limb on Gait ability in chronic stroke patients

Objectives: Recently, use of the Hybrid Assistive Limb (HAL) that is effective for improvement of gait ability in chronic stroke patients has been reported. However, how long the effects are maintained remains unknown. The purpose of the present study was to investigate whether the effect of gait training using the HAL on gait ability was maintained for 3 months after the intervention.

Methods: A longitudinal, observational study with an intervention for a single group that adhered to the STROBE guidelines was performed. Nine chronic stroke patients were enrolled in this study. The patients performed gait training sessions using the HAL, 2–5 sessions/week for 3 weeks. Gait speed, stride length, cadence, and 2-minute walk distance (2MWD) were measured before and after intervention and at 3-month follow-up. The clinical trial registration number of this study is UMIN000012764 R000014756.

Results: Compared to the initial status, gait speed (p = .02), stride length (p = .03), cadence (p = .01), and 2MWD (p < .05) were significantly increased immediately after the intervention. Moreover, gait speed (p < .01), cadence (p = .03), and 2MWD (p = .02) remained significantly higher 3 months after the intervention. There were no significant changes in all outcome measures between after intervention and at 3-month follow-up.

Conclusions: This study showed that gait training using the HAL resulted in significant improvement of gait ability after the intervention and the effect was maintained for 3 months after the training.     

Robot-assisted gait training using a very small-sized Hybrid Assistive Limb® for pediatric cerebral palsy: A case report

PurposeGait parameters and gross motor function improve after 12 sessions of small-sized Hybrid Assistive Limb® (S-HAL) training in adult cerebral palsy (CP) patients. However, there are no reports on repetitive robot-assisted gait training using the newly developed very small-sized HAL (2S-HAL). This study aimed to examine the effect of using 2S-HAL on a pediatric CP patient.MethodsThe subject was an 11-year-old boy (height = 138 cm, weight = 30 kg) with spastic quadriplegia due to periventricular leukomalacia, with Gross Motor Function Classification System level IV. HAL training was performed for 2–4 sessions/week for 20 min/session (i.e., 4-week period with 12 sessions). Outcome measures were walking ability, gross motor function, Canadian Occupational Performance Measure (COPM), and Pediatric Evaluation of Disability Inventory measured before, after, and at 1, 2, and 3 months after HAL-assisted gait training.ResultsAfter HAL intervention, gait speed, step length, cadence, 6-min walking distance (6MD), Gross Motor Function Measure (GMFM), and COPM increased and physiological cost index (PCI) declined compared to those before intervention.The peaks of gait speed, step length, and cadence were 2 month, 1 month, and 3 month, respectively. 6MD, PCI, and GMFM at 1–3 months post-intervention were maintained. COPM peaked at 1 month post-intervention but remained higher than that before intervention.ConclusionThis is the first report of repetitive intervention using 2S-HAL in a pediatric CP patient. Gait training using 2S-HAL may be effective in CP patients as it improves post-training walking ability and gross motor function.     

双任务步行对缺血性卒中患者认知-运动干扰的影响研究

目的 探讨缺血性卒中患者和健康人在进行双任务步行(dual-task walking,DTW)时,不同认知任务对步态和认知-运动干扰(cognitive-motor interference,CMI)的影响.方法 选取24例急性缺血性卒中患者为卒中组,并选取与卒中组性别、年龄、受教育程度相匹配的16例健康志愿者为对照组...     

Improving gait and promoting retention in individuals with Parkinson’s disease: a pilot study

We examined intensive walking practice using two instructional strategies on gait in Parkinson’s disease (PD) before and after training and on delayed retention tests. During four training sessions (15 practice trials of walking per session), subjects (N = 6 per group) were given either verbal instruction (VI) to “take a big step” or VI plus augmented feedback (FB). For FB, videotape performance-feedback (from prior trial) supplemented by performance-cues (for subsequent trial) was given after each trial. On pre- and posttests (1 week after training), the only instructions were to “walk as well as you can.” For available subjects (N = 7), retention was tested at 3, 6, or 12 months after training. Gait parameters were derived from kinematic analysis of walking during training and testing. From pre- to posttests, stride length, walking velocity and shoulder excursion increased significantly, with no change in cadence. Improvements in stride length and gait velocity above pretest levels were maintained on retention tests. During training and testing, no effects of VI versus VI + FB were found. Although the two instructional strategies did not differ, intensive practice walking with VI improved the gait pattern of individuals with PD and these gait improvements were maintained over an extended period of time.     

Effect of Robot Assisted Gait Training on Motor and Walking Function in Patients with Subacute Stroke: A Random Controlled Study

BackgroundRobot-assisted gait training has been confirmed to have beneficial effect on the rehabilitation of stroke patients. An exoskeleton robot, named BEAR-H1, is designed to help stroke patients with walking disabilities.Methods17 subjects in experimental group and 15 subjects in control group completed the study. The experimental group received 30 minutes of BEAR-H1 assisted gait training(BAGT), and the control group received 30 minutes of conventional training, 5 times/week for 4weeks. All subjects were evaluated with 6-minute walk test (6MWT), Fugl-Meyer Assessment for lower extremity (FMA-LE), Functional Ambulatory Classification (FAC), Modified Ashworth Scale (MAS), and gait analysis at baseline and after 4 weeks intervention.ResultsThe improvements of 6MWT, FMA-LE, gait speed, cadence, step length and cycle duration in BAGT group were more noticeable than in the control group. However, there was no difference in the assessment of MAS between two groups.ConclusionsOur results showed that BAGT is an effective intervention to improve the motor and walking ability during 4 weeks training for subacute stroke patients.     

Safety and immediate effects of Hybrid Assistive Limb in children with cerebral palsy: A pilot study

PurposeEarly intervention is effective for developing motor ability and preventing contractures and deformities in patients with cerebral palsy (CP). Gait training using the newly developed Hybrid Assistive Limb (HAL) shows promise as an intervention to prevent deterioration in walking ability and deformities in pediatric CP patients. The purpose of this pilot study was to examine the safety and immediate effects on walking ability after gait training using the HAL in pediatric CP patients.MethodsNineteen patients (six females, 13 males; mean age 8.5 years; mean height 120.5 cm; mean weight 23.2 kg) were enrolled. The Gross Motor Functional Classification Scale level was I in two patients, II in two, III in eight, and IV in seven. The HAL was used for a single session of gait training. The primary outcome was safety of the HAL for use in pediatric CP patients. The secondary outcome was the immediate effect after gait training with HAL, evaluated by passive range of motion (ROM) and gait parameters, including gait speed (m/s), step length (cm), and cadence (step/min).ResultsAll 19 patients were able to carry out the gait training without any severe adverse events. Significant improvements were observed for mean internal/external rotation and abduction angles of the hip joint, and ankle dorsiflexion angles (n = 19). Significant improvements were observed for mean gait speed and step length based on expansion of the hip flexion-extension range (n = 11).ConclusionGait training using the HAL is safe and can produce immediate improvements in ROM and walking ability in pediatric patients with CP.     

Ability to modulate walking cadence remains intact in Parkinson''s disease.

Gait hypokinesia (slowness) is a characteristic feature of Parkinson's disease. It is not clear, however, whether the slowness is due to a problem in regulation of the timing of consecutive steps or the control of stride size. Examination of cadence control for slow to medium walking speeds has shown an increase in step frequency that was a compensation for reduced stride length. In this investigation the ability of Parkinsonian patients to modulate their cadence (steps per minute) at the fast walking speeds exhibited by age and height matched controls was examined. The findings indicated that cadence control remains unaffected throughout its entire range in Parkinson's disease and that gait hypokinesia is directly attributable to an inability to internally generate sufficiently large steps.     

Fatigue leads to gait changes in spinal muscular atrophy

Introduction: Impaired mobility and fatigue are common in ambulatory spinal muscular atrophy (SMA) patients. The 6‐minute walk test (6MWT) is a reliable measure of fatigue in SMA patients. To further evaluate fatigue, we used quantitative gait analysis during the 6MWT. Methods: Nine subjects with SMA and 9 age‐ and gender‐matched, healthy controls were evaluated. Gait parameters of speed and dynamic balance were correlated with 6MWT distance. Performance during the first and last 25 meters of the 6MWT was compared. Results: Speed‐related gait parameters and support base correlated with 6MWT distance. Walking performance was worse for SMA patients. The deterioration in stride length during the 6MWT was greater in SMA patients than in controls. Conclusions: Gait analysis detects fatigue, and the decrement in stride length may reflect selective muscle involvement in SMA. Further understanding of the mechanisms underlying fatigue may suggest additional targets for future therapeutic interventions. Muscle Nerve, 2010     

Effect of cyborg-type robot Hybrid Assistive Limb on patients with severe walking disability in acute stroke: A randomized controlled study

ObjectivesTo investigate whether early gait training using Hybrid Assistive Limb (HAL) is feasible and improves walking and independency compared with conventional physical therapy (CPT) in patients with severe walking disability after stroke.MethodsWe conducted a single-center, randomized controlled study. Patients with first-ever stroke who had severe walking disability were included. All patients started gait training within 10 days post-stroke onset. Twenty-four patients were randomly assigned into HAL or CPT groups. Outcome measures were collected at three time points, at baseline, completion of 20 sessions of gait training (second assessment), and 3 months after the initiation of gait training. The primary outcomes were changes in motor sub-scores of the Functional Independence Measure or Functional Ambulation Category at the completion of the second assessment from baseline.ResultsTwenty-two patients (median age, 68 years; 12 patients in the HAL group and 10 patients in the CPT group) completed the study. There were no significant differences in primary outcomes. Apathy scale, one of the secondary outcomes, showed a decreasing trend in the HAL group (mean change of -3.8, 95% CI -8.14 to 0.475), and a slight increasing trend in the CPT group (mean change of 1.2, 95% CI -2.66 to 5.06) at the second assessment. Patients in the HAL group experienced no adverse events.ConclusionsEarly gait training in patients with severe walking disability after stroke using HAL was feasible. Walking ability and independency were not improved at the completion of 20 sessions of gait training.     

Effects of gait training with a voluntary-driven wearable cyborg,Hybrid Assistive Limb (HAL), on quality of life in patients with neuromuscular disease,able to walk independently with aids

Robot-assisted gait training using a voluntary-driven wearable cyborg, Hybrid Assistive Limb (HAL), has been shown to improve the mobility of patients with neurological disorders; however, its effect on the quality of life (QOL) of patients is not clear. The aim of this study was to assess the effects of HAL-assisted gait training on QOL and mobility in patients with neuromuscular diseases (NMDs). Ten patients with NMDs (seven men and three women, mean age: 57 ± 11 years), with impairment in mobility but could walk alone with aids underwent two courses of gait training with HAL over 6 months, and the single course consisted of nine sessions of training for 4 weeks. We compared the findings of the 2 min walk test, 10 m walk test, the Short Form-36 (SF-36) questionnaire, and the Hospital Anxiety and Depression Scale at baseline, after the 1st training, before the 2nd training, and after the 2nd training using the Friedman test. A significant improvement was observed in the 2 min walking distance from baseline (93 ± 50 m) to after the 2nd training (115 ± 48 m, P = 0.034), as well as in the domains of vitality (P = 0.019) and mental component summary score (P = 0.019) of SF-36. The improvement in 10 m walking speed was significantly correlated with that in the physical functioning (R = 0.831, P = 0.003) and role physical (R = 0.697, P = 0.025) domains in the SF-36. Our findings suggest that HAL-assisted gait training is effective in improving QOL associated with mental health as well as gait ability in selected patients with NMDs.     

The effects of treadmill walking combined with obstacle-crossing on walking ability in ambulatory patients after stroke: a pilot randomized controlled trial

Background and objective: Treadmill walking training (TWT) provides greater amount and intensity of stepping practice than conventional walking training in patients with chronic stroke. However, there is not any conclusive evidence regarding the effects of TWT for ambulatory post-stroke patients. This study investigated the effects of treadmill walking combined with obstacle-crossing on the walking ability of ambulatory post-stroke patients.

Methods: Twenty-nine subjects from a university hospital-based rehabilitation center were randomly assigned to one of the following: experimental group (15 subjects) or control group (14 subjects). All subjects underwent 30 min of active/passive exercises and 30 min of gait training in the form of treadmill walking. The subjects in the experimental group underwent simultaneous training in obstacle-crossing while walking on the treadmill for 30 min/day, 5 times/week, for 4 weeks. Main measures were the 10-m walk test (10MWT), 6-min walk test (6MWT), Berg Balance Scale (BBS), timed “Up & Go” (TUG) test, and Activities-specific Balance Confidence (ABC) scale used before and after the intervention.

Results: The changed values of the 6MWT and BBS were significantly higher in the experimental group than in the control group after adjusting for each baseline value, with large effects of 1.12 and 0.78, respectively, but not in the 10MWT, TUG, and ABC scale scores. Both groups showed a significant difference in all variables before and after the intervention.

Conclusion: Treadmill walking combined with obstacle-crossing training may help improve the walking ability of patients with hemiplegic stroke and can possibly be used as an adjunct to routine rehabilitation therapy as a task-oriented practice based on community ambulation.     

Treadmill walking as an external pacemaker to improve gait rhythm and stability in Parkinson's disease.

Recent reports suggest that external cueing improves stride length and gait speed in Parkinson's disease (PD). The purpose of the present study was to examine the influence of treadmill walking on gait variability. The 36 PD patients (Hoehn and Yahr stage 2--2.5) were compared to 30 controls. Subjects walked three times for 2 minutes each: (1) walking on level ground (unassisted), (2) walking on level ground while using a walker, and (3) walking on a treadmill. Stride time variability and swing time variability were significantly increased in the patients compared to the control subjects when walking on level ground with a walker. In both groups, the use of a walking aid did not significantly affect stride time variability or swing time variability, but the treadmill reduced stride time variability and swing time variability in the patients and in the controls. These results indicate that, during treadmill walking, PD subjects are able to walk with a less variable and more stable gait. Because the treadmill walking speed was set to the gait speed on level ground and because this effect was not seen with a walking aid, we suggest that the treadmill may be acting as an external cue to enhance gait rhythmicity and reduce gait variability.     

Changes in gait and fatigue from morning to afternoon in people with multiple sclerosis

OBJECTIVES: The aim was to measure changes in walking patterns and self rated fatigue in people with multiple sclerosis (MS) compared with age matched control subjects, from the morning to the afternoon within a single day. METHODS: Fourteen patients with MS and the same number of matched control subjects performed four 10 m gait trials at their preferred walking speed at 10 00 am and then again at 3 00 pm on the same day. Gait speed, stride length, cadence, and the percentage of the gait cycle spent in double limb support were measured using a foot switch stride analyzer. Patients with MS also self rated their fatigue levels in the morning and afternoon using an 11 point scale. RESULTS: Compared with control subjects, patients walked very slowly, with reduced stride length and around twice as much variability in gait performance. Although self rated fatigue significantly increased from the morning to the afternoon, walking patterns remained consistent in both groups over the course of the day. CONCLUSIONS: These findings imply that mechanisms controlling locomotion are separate from those regulating perceived fatigue. Objective measures of performance, rather than self report, should be used to monitor change in patients with multiple sclerosis.     

Repeated Use of 6-min Walk Test with Immediate Knowledge of Results for Walking Capacity in Chronic Stroke: Clinical Trial of Fast versus Slow Walkers

Aim: This study aimed to determine the effects of repeated use of the 6-minute walk test (6MWT) with immediate knowledge of results (KR) on the walking capacity by comparing fast and slow walkers in patients with chronic hemiparesis. Methods: Twenty-five subjects were allocated to 2 groups depending on their walking speed¹: Group 1 (fast walkers, n₁ = 11): greater than equal to .8 m/s and² Group 2 (slow walkers, n₂ = 14): less than .8 m/s. All subjects underwent the 6MWT once a day, 5 days a week, for 4 weeks (a total of 20 sessions). The 6MWT was performed on a 30-m path with immediate KR; subjects informed the time taken to walk each 30-m path. Outcome measures included the 6MWT and 10-meter walk test (10MWT). Measurements were taken before and after 4 weeks. Results of within-group comparisons showed significant improvements in the 10MWT and 6MWT for both groups pre- and post-test (P < .05). Furthermore, in between-group comparison, results of Group 1 differences were greater between pre- and post-test in the 10MWT and 6MWT values as compared to Group 2 (P < .05). These findings indicate that repeated use of the 6MWT with immediate KR may be beneficial to enhance walking capacity in patients with chronic stroke, with more favorable changes in better poststroke walking speed.     

Gait disturbances in patients with schizophrenia and adaptation to treadmill walking

This study evaluated the gait patterns of schizophrenic patients at free gait and at three fixed velocities on a treadmill. The effects of illness and antipsychotic treatment on gait parameters and on adaptation to treadmill walking were compared. Gait parameters of 14 drug-naive schizophrenic patients, 14 patients treated with conventional antipsychotics, 14 patients treated with olanzapine, as well as 14 matched controls were assessed on a walkway and on a treadmill at three different velocities (very slow, intermediately slow, and comfortable) using an ultrasonic movement analysis system. At free gait, all patients showed a significantly decreased gait velocity, predominantly due to a shorter stride length, when compared to the controls, with the most striking difference observed between the patients treated with conventional neuroleptics and the controls (ANOVA, P < or = 0.001). Cadence (steps per second) did not differ between the investigated groups. When gait was evaluated on the treadmill, differences in stride length and cadence were significant only at the very slow treadmill velocity (ANOVA, P < or = 0.05). In all patient groups, mean stride length was decreased and cadence compensationally increased. Significant differences between the patient groups were no longer detectable. With increasing treadmill velocities, gait parameters of all patient groups normalized. The results show that, like in patients with Parkinson's Disease, impaired gait parameters can also be normalized in schizophrenic patients by external stimulation via treadmill walking.     

弹性悬带矫形器对偏瘫患者步行功能的影响

目的 评价新型弹力悬带矫形器对患者下肢运动功能及步行功能恢复的效果。方法 28例卒中后偏瘫患者随机被纳入康复治疗组（对照组）和弹力悬带矫形器治疗组（治疗组）,对照组在治疗师指导下进行常规康复训练,治疗组在常规康复训练的基础上佩带弹力悬带矫形器进行步行训练,连续治疗8周。分别于治疗前,治疗后4周和治疗后8周由同一个治疗师对下肢运动功能评分（Fugl-Meyer,FMA）、能量消耗指数（physical consume index,PCI）及包括10 m舒适步行速度和10 m快速步行速度、步频、步长、足偏角、步基宽在内的步态时空参数进行评测,并比较上述指标在治疗前后的变化,观察弹力悬带矫形器的作用效果。结果 治疗4周后,治疗组和对照组10 m舒适步行速度和10 m快速步行速度、步长、步频较治疗前提高（均P＜0.01）,步基宽、PCI较治疗前降低（均P＜0.01）;2组FMA和足偏角治疗前后差异无统计学意义。治疗后治疗组10 m舒适步行速度和10 m快速步行速度、步长较对照组明显提高（P =0.0298,0.0225,0.025）,步基宽、PCI较对照组明显降低（P =0.001,0.026）;2组步频、FMA和足偏角比较差异无统计学意义。治疗8周后,治疗组和对照组的10 m舒适步行速度和10 m快速步行速度、步长、步频及FMA评分较治疗前提高（均P＜0.01）,步基宽、PCI较治疗前降低（均P＜0.01）;2组足偏角治疗前后差异无统计学意义。治疗后治疗组10 m舒适步行速度和10 m快速步行速度、步长、步频及FMA评分较对照组明显提高（P =0.042、0.015,0.024,0.024,0.038）,步基宽、PCI较对照组明显降低（均P＜0.01）;2组足偏角比较差异无统计学意义。结论 早期使用弹力带矫形器可以纠正偏瘫患者的异常步态,提高步行速度,降低能量消耗,促进步行功能恢复。     

Abnormalities of the spatiotemporal characteristics of gait at the onset of freezing in Parkinson's disease.

We investigated the spatiotemporal variables of gait leading up to freezing. Gait analysis was carried out on 14 patients with Parkinson's disease in the off phase of the medication cycle. A computerised, three-dimensional gait analysis system was used to measure the walking pattern. After several trials of normal walking with voluntary stopping, distracting manoeuvres and obstacles on the walkway were used to provoke freezing or festination. The gait variables of normal (off phase), festinating, prestop, and prefreezing strides were analysed using analysis of variance for repeated-measures. Cadence was excessively increased (68%) and stride length decreased (69%) during festination compared with normal off walking; a pattern which remained pronounced when comparing prefreezing strides with normal stopping. Analysing in more detail the three steps before a freeze, we found a progressive decrease of stride length and stable cadence rates and proportions of double support phases. The relationship between cadence and stride length exhibited an exponential increase of cadence with a decreasing stride length during festination and freezing. Results suggest that freezing is caused by a combination of an increasing inability to generate stride length superimposed on a dyscontrol of the cadence of walking.     

Clinical application of backward walking training to improve walking function,balance, and fall-risk in acute stroke: a case series

Background: With limited inpatient rehabilitation (IR) length of stays for patients post-stroke, it is critical to maximize the effectiveness of interventions to address their balance and gait speed deficits. Backward walking (BW) is an emerging training approach; however, its application to patient populations consistent with those in IR is limited.

Objectives: To describe the effects of an additional BW training program to standard IR care on balance, walking ability and fall-risk in a heterogenic caseload of adults <2 weeks post-stroke with a broad range of lesion locations and physical sequelae.

Methods: Eight patients with first-time stroke (5 male; average age 66.5 ± 11.7 years; average stroke onset 7.6 ± 1.6 days; 6 right hemiparesis) participated in 10-daily sessions that included 20 min of over ground BW training for each session, in addition to standard IR. Standard outcome measures were used to assess balance, walking ability and fall-risk at admission and post-intervention.

Results: All eight patients demonstrated improvements in all outcomes with a clinically meaningful increase in forward walking speed, as measured by 10MWT. Four participants exceeded fall-risk cut-off scores for all balance-related outcome measures.

Conclusions: In a diverse patient population early after stroke, individuals successfully participated in an additional BW training program. Despite the patients’ acuity and severe impairments in walking, significant gains in balance and walking function were noted. This program may be useful in improving outcomes with patient characteristics commonly seen in IR.     

双任务步行对缺血性卒中患者步态参数影响的研究

目的 探讨双任务步行（dual-task walking,DTW）对缺血性卒中患者步态参数的影响。 方法 前瞻性入组2020年6月-2021年3月于首都医科大学附属北京天坛医院康复科住院的缺血性 卒中患者。选择时钟任务作为DTW中的认知任务,受试者依次完成单任务步行（single-task walking, STW）和DTW。使用Codamotion三维动作捕捉系统采集患者执行任务时步态的运动学参数（膝关节、踝 关节活动范围、最大屈膝角度、最大伸膝角度、最大踝背屈角度、最大踝跖屈角度）和时空参数（步 速、跨步长、跨步时间、跨步速度、步长、步长时间、步频、支撑期百分比）,计算时空参数的变异系数。 比较患者进行STW和DTW时上述步态参数的差异。 结果 本研究共纳入28例缺血性卒中患者,男性20例（71.4%）。患者进行STW和DTW时步态的 运动学参数差异无统计学意义。在时空参数方面,与STW时相比,进行DTW时患者的步速降低 （0.69±0.23 m/s vs 0.80±0.27 m/s,P＜0.001）、步长（0.41±0.11 m vs 0.46±0.12 m,P＜0.001）和跨 步长缩短（0.85±0.20 m vs 0.95±0.22 m,P＜0.001）。在时空参数变异性方面,与STW比较,卒中患 者进行DTW时步长时间变异性[4.47（2.98～7.34）vs 2.58（1.76～4.27）,P＝0.013]及步频变异性[4.59 （2.78～7.78）vs 2.71（1.84～4.44）,P＝0.020]增加。 结论 卒中患者在进行DTW时更容易发现步态问题。与STW相比,双任务条件下的步态评估可能是 更有效的卒中康复评估指标,也更适用于卒中后康复训练计划。