Effects of Backward Walking Training on Static Balance, Balance Confidence, and Walking Endurance of Patients with Chronic Stroke

The effects of lower extremity cross-training on gait and balance in stroke patients: a double-blinded randomized controlled trial

BACKGROUND

Cross-training is an indirect intervention to promote muscle activity on the affected side by applying resistance exercise to stronger parts of the body. Indirect interventions are useful for treating patients who have difficulty with direct interventions. Previous studies have focused on measuring increased muscle strength and muscle activity in healthy individuals.

AIM

This study aimed to investigate the effects of cross-training on gait and balance in hemiplegic patients when applied to the affected and unaffected lower extremities.

DESIGN

Double-blinded randomised controlled trial.

SETTING

In-patients attending the rehabilitation treatment room of a single center.

POPULATION

Fifty-two stroke patients were randomly allocated to a control group (N.=19), affected side cross-training group (N.=15), and unaffected side cross-training group (N.=18).

METHODS

Patients were administered general neurological physiotherapy for 30 mins, twice daily, 5 days/week for 4 weeks. The two intervention groups underwent 30 mins of cross-training instead of general neurological physiotherapy once daily, 3 days/week for 4 weeks (postintervention). For data analysis, one-way ANOVA for between-group comparisons and paired t-tests were performed for within-group comparisons between pre- and postintervention groups (significance level of 0.05).

RESULTS

In the Timed Up and Go Test (TUG), comparing pre- and postintervention, the control group showed no significant change (P>0.05), while the affected side and unaffected side cross-training groups showed significant improvements in function (P<0.05). In the 10-meter Walk Test, the control group showed no significant change (P>0.05), while the affected side and unaffected side cross-training groups showed significant increases in speed (P<0.05). In balance testing, the limits of stability showed a significantly increase in all three groups (P<0.05). There were no pre- or postintervention differences in gait or balance between the groups (P>0.05).

CONCLUSIONS

Gait and balance improved in hemiplegic stroke patients who participated in cross-training, regardless of the intervention applied to the affected or unaffected side.

CLINICAL REHABILITATION IMPACT

In clinical settings, for patients who experience difficulties with direct interventions on the affected side, we propose indirect interventions to improve gait and balance.