Dynamic biomechanical effect of lower body positive pressure treadmill training for hemiplegic gait rehabilitation after stroke: A case report

Figure 1 Brain magnetic resonance imaging obtained 27 mo after stroke showed abnormal signals in the right part of the pons. A-C: The signals are hypointense on T1-weighted imaging (T1WI) (A, orange arrow) as well as fluid-attenuated inversion recovery (C, orange arrow) and hyperintense on T2-weighted imaging (T2WI) (B, orange arrow); D: Magnetic resonance angiography revealed arteriosclerosis in bilateral siphon arteries.

Figure 2 Timeline for the whole evaluation and intervention process. The lower body positive pressure training was performed one session per day and six times per week for 2 wk. The plantar pressure analysis was performed on days 1 (baseline/pre-treatment), 4, 7, 11, 14 (post-treatment), and 28 (follow-up). Lower extremity subscale of the Fugl–Meyer Assessment, Berg Balance Scale, Timed Up and Go test, and three-dimensional gait analysis were assessed on days 1 (pre-treatment), 14 (post-treatment), and 28 (follow-up). FMA-LE: Lower extremity subscale of the Fugl–Meyer Assessment; BBS: Berg Balance Scale; TUG: Timed Up and Go test; 3D: Three-dimensional.

Figure 3 Plantar pressure distributions measured on days 1 (baseline/pretreatment), 4, 7, 11, 14 (posttreatment), and 28 (follow-up) on the affected side and unaffected side. A: Affected side; B: Unaffected side.

Figure 4 Symmetric index of mean muscle activity computed during stance phase and swing phase. The lower the value of the symmetric index, the lesser the difference between the affected side and the unaffected side. During both the stance phase and swing phase, the symmetry of muscle activities (including the tibialis anterior, gastrocnemius lateralis, and gastrocnemius medialis) were better posttreatment than pretreatment. The symmetry of gastrocnemius medialis activities were slightly worse at follow-up. A: Stance phase; B: Swing phase.