Roads to recovery

Balance and gait problems are very important aspects of stroke-related disability, for which effective rehabilitation protocols are currently lacking. Preliminary evidence suggests that intensive, perturbation-based balance and gait training is able to improve the neuromuscular control of balance and gait, even in the chronic phase of stroke. Yet, the effects of perturbation-based training on the neuromuscular control of balance and gait remain to be established. This study will provide novel insights into the effects of perturbation-based training, thereby allowing for fine-grain characterization of the trajectories of motor recovery after stroke.

We hypothesize that perturbation-based training improves the neuromuscular control of balance and gait by normalizing muscle coordination (expressed in terms of muscle synergies), in contrast to conventional physiotherapy.

Week 1. Intake and clinimetric evaluation.
Week 2. Pre-intervention assessment of balance and gait.
Week 3-7. Experimental intervention group: perturbation-based training protocol for balance and gait. Regular care group: conventional physiotherapy.
Week 8. Post-intervention clinimetric evaluation and assessment of balance and gait.
Follow-up: Monthly collection of fall-registration cards for six months.

Participants will be randomly assigned to either an experimental intervention or regular care group. The experimental intervention group will receive a perturbation-based training protocol in which an instrumented treadmill will induce reactive balance movements and gait adaptation during walking. The regular care group will receive conventional physiotherapy. Both groups will receive training in sessions of one hour, two times a week, during five weeks.