Article

OBJECTIVE: To determine whether external feedback to promote symmetrical weight
distribution during standing and walking would improve gait performance and
balance in people with stroke. DESIGN: Randomized, controlled, assessor-blinded
trial. SETTING: Rehabilitation unit and physical therapy department. SUBJECTS:
Thirty-five individuals with stroke (mean (SD) age = 53.0 (9.3) years) were
randomly assigned to an experimental (n = 17) or control group (n = 18). Time
post stroke was less than six months for most subjects
(n = 27, 77%).
INTERVENTIONS: Subjects participated in 15 rehabilitation sessions including 30
minutes of gait retraining per session. During gait retraining, the experimental
group used an insole shoe wedge and sensors set-up (I-ShoWS) while the control
group received a conventional programme. The I-ShoWS set-up consisted of a wedge
insole and a footswitch for the non-paretic leg and a pressure sensor on the
paretic leg. OUTCOME MEASURES: Gait speed, step length and single support time
asymmetry ratio, balance and amount of load on paretic leg during stance were
evaluated twice: one day before and after training. RESULTS: The experimental
group demonstrated significant increase in standing and gait symmetry compared
with the control group (P < 0.05). They demonstrated 3 times greater improvement
in gait speed than the control group (P = 0.02). Balance improvement was
significantly greater for the experimental than for the control group (P < 0.05).
CONCLUSION: Gait retraining using the I-ShoWS set-up was more effective in
restoration of gait speed, standing and walking symmetry and balance than a
conventional treatment programme. These results indicate the benefit of
implementing feedback during gait retraining.

Langue : ANGLAIS