Article

The aim of this study was to identify a gait training type that better improves
the walking and balancing abilities of adult patients with chronic hemiplegic
stroke. Single-blinded, randomized, controlled, comparative preliminary study was
carried out. Patients were recruited from the inpatient unit of a Rehabilitation
Hospital. Thirty-one patients who had experienced hemiplegic stroke were randomly
assigned to three groups: the heel group (gait training by active weight bearing
on the paretic heel with auditory feedback), the forefoot group (gait training
with auditory feedback from paretic metatarsals), and the control group (general
gait intervention). All patients performed 30 min of comprehensive rehabilitation
therapy followed by an additional 20 min of gait intervention with or without
auditory feedback three times a week for 6 weeks. Significant improvements in
walking and balancing variables were observed after gait training in all three
groups (P<0.05). However, significantly larger gains were identified in the heel
group than in the control group (center of loading path length, -29.4 vs. -11.4%,
d=-1.0; center of loading path velocity, -35.8 vs. -19.6%, d=-1.4). In addition,
significantly larger gains were observed in the forefoot group than in the
control group (functional gait assessment, +42.6 vs. +20.1%, d=1.3; center of
loading path length, -37.2 vs. -11.4%, d=-1.8; center of loading path velocity,
-36.0 vs. -19.6%, d=-1.3). Auditory feedback during active weight bearing on
paretic feet appears to more effectively improve the walking and balancing
abilities of hemiplegic stroke patients than general gait training.

Langue : ANGLAIS