American Journal of Physical Medicine & Rehabilitation · Oct 4, 2019

Effects of Load Addition During Gait Training on Weight-Bearing and Temporal Asymmetry After Stroke: A Randomized Clinical Trial

By Ribeiro TS, Gomes de Souza E Silva EM, Regalado ICR et al.

OBJECTIVE: The aim of the study was to evaluate the effects of adding load to restrain the nonparetic lower limb during gait training on weight-bearing and temporal asymmetry after stroke. DESIGN: Thirty-eight subjects were randomized into treadmill training with load (5% of body weight) on the nonparetic limb (experimental group) and treadmill training without load (control group). Interventions lasted 30 mins/d for 2 wks (9 sessions). Both groups performed home-based exercises and were instructed to increase the use of paretic limb in daily life situations. Ground reaction force was obtained by a force plate during standing position (static) and gait (dynamic). Temporal gait parameters were assessed by a motion system analysis. Outcome measures were evaluated at baseline, posttraining, and after a 40-day follow-up. RESULTS: The experimental group increased static ground reaction force of the paretic limb at posttraining (P = 0.037) and the control group increased dynamic ground reaction force of the paretic limb at posttraining (P = 0.021), both with maintenance at follow-up. Neither group showed a change in the swing time symmetry ratio after training (P = 0.190). CONCLUSIONS: Treadmill training associated with behavioral strategies/home-based exercises seemed to be useful to minimize weight-bearing asymmetry, but not to improve temporal gait asymmetry. Load addition did not show additional benefits.

doi.org/10.1097/phm.0000000000001314PubMed 31584453Interventions