Effects of Foot Position-Based Gait Training on Muscle Activity, Gait Parameters, and Balance in Subacute Stroke Patients

Abstract

Background: the effects of gait training based on the positioning of affected foot muscle activity, gait parameters, and balance ability were investigated in patients with subacute stroke. Material and Methods: Forty-five patients with subacute stroke were randomly assigned to three groups: straight gait training (SGT) group (n = 15), outward curved gait training group (OCGT) with the paretic foot positioned laterally (n = 15), or inward curved gait training (ICGT) group with the paretic foot positioned medially (n = 15). All groups received 30 min interventions, comprising 15 min of gait training, five times per week for four weeks. Outcomes were measured in terms of muscle activation of the gluteus maximus (GM), vastus medialis, and vastus lateralis; five gait parameters (step length, stance phase, swing phase, velocity, and maximum force); and balance ability assessed using the timed up and go (TUG) test. Results: All groups exhibited significant improvements in all variables after the four-week intervention period (p < 0.05). Specifically, the overall muscle activation and gait parameters for each group increased as follows: the SGT showed increases of 38.8% and 5.7%, respectively; the OCGT exhibited improvements of 38.9% and 7.4%; and the ICGT demonstrated enhancements of 59.8% and 9.2%. However, except for comparisons between the SGT and ICGT groups in terms of GM muscle activity and TUG, no significant differences were observed between the groups for the other variables (p > 0.05). Conclusions: although patients with subacute stroke can improve their overall physical function regardless of the gait training method, ICGT may be more effective in enhancing muscle activity and balance ability.