Krishnan V, Khoo I, Marayong P, DeMars K, Cormack J
Department of Physical Therapy, California State University, Long Beach, CA 90840, USA.
Electrical Engineering Department, California State University, Long Beach, CA 90840, USA.
Neurosci J. 2016;2016:6808319. doi: 10.1155/2016/6808319. Epub 2016 Nov 24.
Asymmetrical gait and a reduction in weight bearing on the affected side are a common finding in chronic stroke survivors. The purpose of this pilot study was to determine the effectiveness of a shoe insole device that we developed, called Walk-Even, in correcting asymmetric gait in chronic stroke survivors. Six individuals with chronic (>6 months) stroke underwent 8 weeks of intervention with 2 sessions/week, each consisting of 20 minutes of gait training and 20 minutes of lower-extremity strength training. The 2 control participants underwent conventional gait training, while 4 participants underwent gait training using the Walk-Even. Following intervention, all the participants improved on most of the gait measures: peak pressure of the foot, time of transfer of weight from heel-to-forefoot, center of pressure (COP) trajectory, COP velocity, asymmetry ratio of stance, mean-force-heel, mean-force-metatarsals, Timed "Up and Go," and Activities-specific Balance Scale. The improvement was more pronounced in the 4 participants that underwent training with Walk-Even compared to the control participants. This pilot study suggests that a combination of strength and gait training with real-time feedback may reduce temporal asymmetry and enhance weight-bearing on the affected side in chronic stroke survivors. A large randomized controlled study is needed to confirm its efficacy.
不对称步态以及患侧负重减少是慢性中风幸存者的常见表现。这项初步研究的目的是确定我们研发的一种名为Walk-Even的鞋垫装置在纠正慢性中风幸存者不对称步态方面的有效性。六名患有慢性（>6个月）中风的个体接受了为期8周的干预，每周2次，每次包括20分钟的步态训练和20分钟的下肢力量训练。2名对照参与者接受传统步态训练，而4名参与者使用Walk-Even进行步态训练。干预后，所有参与者在大多数步态指标上都有改善：足部峰值压力、从脚跟到前脚掌的重量转移时间、压力中心（COP）轨迹、COP速度、站立不对称率、平均足跟力、平均跖骨力、定时起立行走测试和特定活动平衡量表。与对照参与者相比，使用Walk-Even进行训练的4名参与者的改善更为明显。这项初步研究表明，力量训练和步态训练与实时反馈相结合可能会减少慢性中风幸存者的时间不对称性，并增强患侧的负重能力。需要进行大规模随机对照研究来证实其疗效。
