The effect of elastic band assisted gait training to improve the gait kinematics in stroke survivors - a randomized control trial

Abstract

Introduction: Stroke is the leading cause of serious long-term disabilities, the restoration of walking plays a prime role in his rehabilitation. The reduction in gait performance may prevent the resumption of activities of daily living. Aim of the study: To compare the effectiveness of elastic band assisted gait training over the task-oriented circuit interval gait training in stroke survivors. Methodology: A total of 50 male stroke survivors with functional ambulatory category score ≥4, mini mental state 24-30, normal cardio-pulmonary status and age between 30-60 years were recruited and randomly distributed in two groups. Group 1 received conventional exercises (task-oriented approach in the form of circuit interval gait training) and Group 2 received elastic band assisted gait training with task-oriented approach in the form of circuit interval gait training. Outcome measures: Stride length (both side), cadence, walking speed and gait profile score (both side). Measurements were taken with gait laboratory before and at the end of 6 weeks of treatment, for 45 minutes divided into nine 5-minute blocks separated by 5-minute rest periods 5 days/week. Results: Overall result of this study showed that experiment group had significantly improved in terms of speed, cadence, stride length of paretic limb, gait profile score of non paretic limb from pre to post test measurements, but no significant improvement in conventional group. Gait profile score of paretic limbs had significantly improved. Both the groups had significantly improved in terms of stride length of non paretic limb from pre to post-test measurements; however, the experiment group showed more improvement than the conventional group. Conclusion: Elastic band assisted gait training over the task-oriented circuit interval gait training is found to be effective for the hemiplegic gait. *Correspondence to: Patitapaban Mohanty, PhD, Assoc. Prof. (PT), Swami Vivekanand National Institute of Rehabilitation Training and Research, Olatpur, Bairoi, Cuttack, India, E-mail: ppmphysio@rediffmail.com Received: May 13, 2019; Accepted: June 18, 2019; Published: June 21, 2019 Introduction Stroke is the leading cause of serious long-term disabilities, including loss of motor, sensory or cognitive function [1]. The restoration of walking plays a prime role in rehabilitation [2]. The reduction in gait performance may prevent the resumption of activities of daily living, which can have an adverse effect on perceived participation [3]. Hemiparetic gait pattern is characterized by being stereotyped with reduced weight bearing on the paretic lower limb. Over activity or shortening of plantar flexor muscles at swing phase giving the equinovarus foot placement [4]. Reduced knee flexion, exaggerated hip circumduction and hip hiking during the swing phase are a common disability in people with stroke [5]. Which movements are energetically demanding and may lead to chronic joint pain [6,7]. Manual assistance during gait training is necessary to properly align the trunk and guide the lower extremity through normal gait trajectory. It is difficult to consistently and adequately control the patient and manually assist dorsiflexion during the swing phase of gait; it can be exhausting and place the physical therapist in a nonergonomic position [8]. There exist devices like Hip flexion orthosis [9], Elastic band orthosis [10], Wearable tubing assistive walking device [11], AFO shaped band [12] and wearable tubing to address ankle dorsiflexion, hip and knee flexion with patient either in non-weight or weight bearing positions. Elastic resistance training has been reported to increase gait, mobility, balance and reduced pain [8-15]. Apart from its use in strengthening program, elastic band can also be used in assisted gait training [15].