Abstract

Chronic stroke leads to the impairment of lower limb function and gait performance. After in-hospital rehabilitation, most individuals lack continuous gait training because of the limited number of physical therapists. This study aimed to evaluate the effects of a newly invented gait training machine (I-Walk) on lower limb function and gait performance in chronic stroke individuals. Thirty community-dwelling chronic stroke individuals were allocated to the I-Walk machine group (n = 15) or the overground gait training (control) group (n = 15). Both groups received 30 min of upper limb and hand movement and sit-to-stand training. After that, the I-Walk group received 30 min of I-Walk training, while the control followed a 30-minute overground training program. All the individuals were trained 3 days/week for 8 weeks. The primary outcome of the motor recovery of lower limb impairment was measured using the Fugl–Meyer Assessment (FMA). The secondary outcomes for gait performance were the 6-minute walk test (6 MWT), the 10-meter walk test (10 MWT), and the Timed Up and Go (TUG). The two-way mixed-model ANOVA with the Bonferroni test was used to compare means within and between groups. The post-intervention motor and sensory subscales of the FMA significantly increased compared to the baseline in both groups. Moreover, the 6 MWT and 10 MWT values also improved in both groups. In addition, the mean difference of TUG in the I-Walk was higher than the control. The efficiency of I-Walk training was comparable to overground training and might be applied for chronic stroke gait training in the community.

Highlights

  • Introduction published maps and institutional affilStroke is a major cause of death and global disability [1]

  • This study aimed to examine the effects of an innovative gait training machine (I-Walk) on motor control and gait performance in community-dwelling persons with hemiparesis after a stroke

  • Our study suggested an increment of gait speed with the I-Walk training group higher than 1.4 m/s with 81.2 m, which is higher than the minimally clinically important difference (MCID) [43]

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Summary

Introduction

Stroke is a major cause of death and global disability [1]. Thirty percent of stroke survivors are incapable of walking independently [2]. Gait training by physical therapists is mainly available only in the poststroke acute phase for a short period [3]. Gait speed is an important indicator of community ambulation associated with walking competency. Greater gait speed suggests good functioning and better quality of life [4,5].

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