Evaluation of Out-patient Physiotherapy and a Home Exercise Program in the Management of Gait Asymmetry in Residual Stroke

Abstract

This article investigates the relative effectiveness in the ways in which physiotherapy exercises are administered to patients with residual stroke. The exercises were designed to improve walking by increasing the ability of the affected limb to bear weight during the single support phase of the gait cycle and, therefore, to increase the duration of this phase, thereby making the gait pattern more symmetrical. Twenty patients were divided into four equal groups, one of which acted as a control, receiving no treatment. The other three groups received exercises for two 1-h sessions per week supervised by a physiotherapist in an outpatient facility (group A), by a spouse or companion at home (group B), or by a combination of these (group C). Treatment was given for 6 months with assessments at monthly intervals during and for 3 months posttreatment. Results from this study indicate that on any given visit there were no differences between any of the four groups with respect to increasing the duration of single support on the affected side nor gait symmetry nor walking speed. When each group was compared to pretest data, only walking speed was found to increase significantly, but even this improvement, seen only in the treatment groups, was inconsistent and not maintained. The possible reasons for these results and their implications for rehabilitation are discussed.