The Differential learning effect on lower limb function and gait in post-stroke patients

Abstract

Introduction. Lower limbs muscle weakness and neurological gait disorders are a major problem for many post-stroke patients as it results in an inability to perform daily activities (1, 2). The differential learning approach is characterized by: taking advantage of fluctuations that occur without movement repetitions and - the need of corrections during the primary acquisition process (3). The aim of differential learning is to support subject to find his/her individual context-dependent performance repertoire in order to perform a complex motor skill as successfully as possible (4). The aim: to assess the differential learning effect on lower limb function and gait in post-stroke patients. Research methods and organization. Participants and methodology. Participants were recruited from Kaunas Hospital of Lithuanian University of Health Sciences and took part in the study during the period from 03/08/2019 to 16/10/2020. Participants signed informed consent and were involved in the study that was approved by the local bioethics center (No. BEC-SR(M)-182). The study included 26 subjects (age 73.77 ± 8.71 years) who suffered a stroke. Participants were randomly divided into two equal groups formed by 13 participants each. The first group was called a repetition-based group (RG) (age 73.69 ± 9.09 years) and the second was a differential learning-based group (DLG) (age 73.85 ± 8.67 years). Post-stroke patients in total had 10 individual physiotherapy sessions twice a day (30 and 35 minutes long). DLG and RG groups underwent a common exercise program consisting of muscle strengthening, mobility training, trunk control and balance developing exercises. The DLG group received additional differential learning approach exercises 3 times a week (6 sessions in total). RG group performed regular lower limb function and gait improving exercises 3 times a week (6 sessions in total). Before and after physiotherapy lower li[...].