[Abstract] Effects of treadmill training with load addition on non-paretic lower limb on gait parameters after stroke: a randomized controlled clinical trial

Highlights

  • Load use as a restraint for the movement of non-paretic lower limb is proposed.
  • Currently, only immediate effects of this practice are available.
  • Stroke patients performed gait training with and without load addition, for two weeks.
  • Kinematic gait parameters were improved after training and maintained at follow-up.
  • Load addition did not provide additional benefits to gait training.

Abstract

The addition of load on the non-paretic lower limb for the purpose of restraining this limb and stimulating the use of the paretic limb has been suggested to improve hemiparetic gait. However, the results are conflicting and only short-term effects have been observed.

This study aims to investigate the effects of adding load on non-paretic lower limb during treadmill gait training as a multisession intervention on kinematic gait parameters after stroke.

With this aim, 38 subacute stroke patients (mean time since stroke: 4.5 months) were randomly divided into two groups: treadmill training with load (equivalent to 5% of body weight) on the non-paretic ankle (experimental group) and treadmill training without load (control group). Both groups performed treadmill training during 30 minutes per day, for two consecutive weeks (nine sessions). Spatiotemporal and angular gait parameters were assessed by a motion system analysis at baseline, post-training (at the end of 9 days of interventions) and follow-up (40 days after the end of interventions).

Several post-training effects were demonstrated: patients walked faster and with longer paretic and non-paretic steps compared to baseline, and maintained these gains at follow-up. In addition, patients exhibited greater hip and knee joint excursion in both limbs at post-training, while maintaining most of these benefits at follow-up. All these improvements were observed in both groups.

Although the proposal gait training program has provided better gait parameters for these subacute stroke patients, our data indicate that load addition used as a restraint may not provide additional benefits to gait training.

Source: Effects of treadmill training with load addition on non-paretic lower limb on gait parameters after stroke: a randomized controlled clinical trial – Gait & Posture

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