Randomized comparison trial of gait training with and without compelled weight-shift therapy in individuals with chronic stroke

Abstract

Objective: To compare the effects of gait training combined with compelled weight-shift therapy and gait training alone on velocity and gait symmetry in patients with chronic stroke. Design: Single-blind randomized controlled trial. Participants: Patients (N=28) with chronic stroke and stance asymmetry toward the non-paretic side. Interventions: Six weeks of gait training combined with compelled weight-shift therapy via a shoe lift applied under the non-paretic leg (experimental group, n=14) or gait training alone (control group, n=14). Main measures: Percentage of total body weight carried by the paretic limb, gait velocity and gait spatiotemporal symmetry ratios including step symmetry, stance symmetry, swing symmetry and overall temporal symmetry. Results: When comparing the two groups, weight bearing on the affected side increased more significantly in experimental group than in control group (40.14±3.77, 38.28±4.06) after the end of treatment and also after a three-month follow-up (44.42±3.5, 38.5±3.77) (P<0.05). Among the experimental and control groups, there were no significant differences of gait velocity (cm/s) after six weeks of treatment (49.82±16.82, 42.66±18.75) and also after a three-month follow-up (50.94±16.27, 41.66±17.58) (P>0.05). There were no significant differences of gait spatiotemporal symmetry ratios including step symmetry, stance symmetry, swing symmetry and overall temporal symmetry between the two groups after six weeks of treatment and also at three-month follow-up (P>0.05). Conclusions: This study did not confirm that the effect of gait training combined with compelled body weight shift therapy was better than gait training alone on improving velocity and gait symmetry in patients with chronic stroke.