Feedback to patients as to how they perform motor tasks during gait rehabilitation has been shown to improve performance and learning. Taking into consideration all types of sensory feedback, in aggregate was associated with significant short and long-term outcomes .
Symmetric movements of the paretic and nonparetic limb related with bilateral training reduce the disinhibition of the corticomotor networks and improve the motor control .
People who receive electromechanical-assisted gait training in combination with physiotherapy after stroke are more likely to achieve independent walking than people who receive gait training without these devices .
They are significantly higher rates of independent walking in end-effector compared with exoskeleton-based training .
Post-stroke rehabilitation increases motor brain reorganization, while lack of rehabilitation reduces reorganization. Functional reorganization of cortex is greater for tasks that are meaningful; repetitive activity is not enough . More intensive motor training increases brain reorganization. The greater the intensity of therapies, the better the outcomes .
As with all aspects of stroke rehabilitation, the training regimen should emphasize repetition, gradually progressive task difficulty, adaptive training and functional practice ,. Patients should engage in training that is meaningful, engaging, progressively adaptive, intensive, task-specific and goal-oriented in an effort to improve transfer skills and mobility. Patients should receive rehabilitation therapies of appropriate intensity and duration, individually designed to meet their needs for optimal recovery and tolerance levels . Interventions involving repetitive practice improve strength after stroke, and these improvements are accompanied by improvements in activity .
Solutions, which allow efficient use of the physical therapist’s time, are requested. Therapies that make possible for patients to exercise for longer within the same available time slot, which may save costs, are more and more necessary . There is an association between effect size and additional treatment time .
Periodic assessments with the same standardized tools to document progress in rehabilitation are needed .
When spasticity is present, the cost of care is 4 times higher than when spasticity is absent. The prevalence of post stroke spasticity in any limb is in the range of 25% to 43% over the first year after stroke .