Effects of Load Addition During Gait Training on Weight-Bearing and Temporal Asymmetry After Stroke

Abstract

Objective The aim of the study was to evaluate the effects of adding load to restrain the nonparetic lower limb during gait training on weight-bearing and temporal asymmetry after stroke. Design Thirty-eight subjects were randomized into treadmill training with load (5% of body weight) on the nonparetic limb (experimental group) and treadmill training without load (control group). Interventions lasted 30 mins/d for 2 wks (9 sessions). Both groups performed home-based exercises and were instructed to increase the use of paretic limb in daily life situations. Ground reaction force was obtained by a force plate during standing position (static) and gait (dynamic). Temporal gait parameters were assessed by a motion system analysis. Outcome measures were evaluated at baseline, posttraining, and after a 40-day follow-up. Results The experimental group increased static ground reaction force of the paretic limb at posttraining (P = 0.037) and the control group increased dynamic ground reaction force of the paretic limb at posttraining (P = 0.021), both with maintenance at follow-up. Neither group showed a change in the swing time symmetry ratio after training (P = 0.190). Conclusions Treadmill training associated with behavioral strategies/home-based exercises seemed to be useful to minimize weight-bearing asymmetry, but not to improve temporal gait asymmetry. Load addition did not show additional benefits.

Effect of Treadmill Training Interventions on Spatiotemporal Gait Parameters in Older Adults with Neurological Disorders: Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Of the 214 articles subjected to full-text screening, 182 were excluded due to the reasons outlined in Figure 1 . The remaining 32 articles [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ] were included in qualitative synthesis for the review.…”

“…Nineteen studies contain adults with history of stroke [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ] and 13 studies contain adults with Parkinson’s disease [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. When examining the studies that included a stroke population, 55.5% of the studies contained adults with chronic stroke [ 14 , 15 , 16 , 18 , 19 , 20 , 21 , 27 , 30 , 31 , 32 ] and 27.8% of the studies contained adults with acute or subacute stroke [ 23 , 24 , 25 , 27 , 29 ]. Eleven studies included adults with both hemorrhagic and ischemic stroke [ 14 , 18 , 19 ,…”

“…When examining the studies that included a stroke population, 55.5% of the studies contained adults with chronic stroke [ 14 , 15 , 16 , 18 , 19 , 20 , 21 , 27 , 30 , 31 , 32 ] and 27.8% of the studies contained adults with acute or subacute stroke [ 23 , 24 , 25 , 27 , 29 ]. Eleven studies included adults with both hemorrhagic and ischemic stroke [ 14 , 18 , 19 , 20 , 21 , 24 , 27 , 29 , 30 , 31 , 32 ]. One study contained adults with only ischemic stroke [ 16 ].…”

“…Among the final list of studies used for the review, the two disease populations mentioned are stroke and PD. Nineteen studies contain adults with history of stroke [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] and 13 studies contain adults with Parkinson's disease [33][34][35][36][37][38][39][40][41][42][43][44][45]. When examining the studies that included a stroke population, 55.5% of the studies contained adults with chronic stroke [14-16,18-21,27,30-32] and 27.8% of the studies contained adults with acute or subacute stroke [23][24][25]27,29].…”

“…In contrast, only 12 studies provided sample size justification, or a power description [14,15,[20][21][22]26,28,29,34,[42][43][44], and 13 studies mentioned confounding variables and statistical adjustments [16,19,21,24,26,28,29,35,36,40,[42][43][44]. Of 32 studies, 30 included an active control group [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][31][32][33][34][35][37][38][39][40][41]…”