The effects of visual information deprivation and feedback balance training on balance in patients with stroke.

BACKGROUND: Patients with stroke depend on visual information due to balance deficits. Therefore, it is believed that appropriate visual deprivation training could have an impact on improving balance abilities. OBJECTIVE: The purpose of this study was to compare the effects of balance training performed in visual deprivation and feedback conditions on balance in stroke survivors. METHODS: The 39 participants were randomly assigned to either the Visual Deprivation Group (VDG; n = 13), the Visual Feedback Group (VFG; n = 13), or the Control Group (CG; n = 13). The training sessions were conducted five times a week for three weeks. Participants completed the Berg Balance Scale (BBS), Timed Up and Go test (TUG), Four Square Step Test (FSST), and Limit of Stability (LOS) assessments. RESULTS: The VDG showed significant improvements in BBS, FSST, TUG, and LOS. In VFG, significant improvements were observed in BBS and TUG. There were statistically significant differences among the groups in all variables related to balance. CONCLUSION: The results of this study suggest that balance training under visual deprivation is effective in improving static and dynamic balance and gait in patients with stroke. In other words, patients with stroke need to reduce their over-reliance on visual information.

Task-Oriented Training with Abdominal Drawing-in Maneuver in Sitting Position for Trunk Control, Balance, and Activities of Daily Living in Patients with Stroke: A Pilot Randomized Controlled Trial.

In many patients with stroke, trunk stabilization and balance are decreased. Trunk stabilization and balance are important to perform posture control and functional movement. This study investigates the effects of task-orientated training with the abdominal drawing-in maneuver in a sitting position on trunk control, balance, and activities of daily living in patients with chronic stroke. The study design is a randomized controlled trial. Thirty-eight patients with chronic stroke participated in this study. The task-oriented training combined with the abdominal drawing-in maneuver group (n = 13), the task-oriented training group (n = 13), and the control group (n = 12) received traditional physical therapy. Three groups participated in a total of 20 sessions, four times a week for five weeks. After the five-week training period, trunk control, balance, and activities of daily living were assessed. The task-oriented training combined with the abdominal drawing-in maneuver group demonstrated significant improvements in trunk control, balance, and activities of daily living compared to the task-oriented training and control groups (p < 0.05). These results have implications for improving trunk control, balance, and activities of daily living for patients with stroke, and support the integration of this training method into standard clinical practice.

Effectiveness of backward walking with functional electrical stimulation on the rectus femoris and tibialis anterior for patients with chronic stroke.

BACKGROUND: Backward walking is considered as a newly rising method used to enhance gait abilities, but evidence remains unclear. OBJECTIVE: To identify whether backward walking with functional electrical stimulation (FES) triggered by a foot switch on the rectus femoris and tibialis anterior could be effective in improving gait parameters of stroke survivors. METHODS: This was a cross-sectional study that included fourteen subjects with chronic stroke. Three walking conditions were performed at random: backward walking with FES attached onto the rectus femoris and tibialis anterior (RF+TA), backward walking with FES attached onto the tibialis anterior (TA only), and without electrical intervention (non-FES). The Zebris was used to assess the spatiotemporal gait parameters. Each condition was measured three times and the average value was used for analysis. RESULTS: Results showed significant increases in gait speed, cadence, step length, mid-stance percentage, maximal force in the affected midfoot (p < 0.05), and significant decreases in the double stance phase in the RF+TA condition compared to the TA only and the non-FES conditions (p < 0.05). CONCLUSION: Functional electrical stimulation to the rectus femoris and tibialis anterior during backward walking could be a clinically effective method to improve gait ability of stroke survivors.

The effects of treadmill training with visual feedback and rhythmic auditory cue on gait and balance in chronic stroke patients: A randomized controlled trial.

BACKGROUND: Many stroke patients show reduced walking abilities, characterized by asymmetric walking patterns. For such patients, restoration of walking symmetry is important. OBJECTIVE: This study investigates the effect of treadmill training with visual feedback and rhythmic auditory cue (VF+RAC) for walking symmetry on spatiotemporal gait parameters and balance abilities. METHODS: Thirty-two patients with chronic stroke participated in this study. Participants were randomized to either the VF+RAC (n = 16) or the Control (n = 16) group. The VF+RAC group received treadmill training with VF and RAC, and the Control group underwent treadmill training without any visual and auditory stimulation. VF+RAC and Control groups were trained three times per week for eight weeks. After eight weeks of training, the spatiotemporal gait parameters, Timed up and go test, and Berg balance scale were measured. RESULTS: The VF+RAC group significantly improved balance and spatiotemporal parameters except for non-paretic single limb support compared to the Control group. CONCLUSIONS: This study demonstrated that treadmill training with VF+RAC significantly improved spatiotemporal gait symmetry, including other gait parameters, and enhanced balance abilities in stroke patients. Therefore, treadmill training with VF+RAC could be a beneficial intervention in clinical settings for stroke patients who need improvement in their gait and balance abilities.

The effects of robot-assisted gait training using virtual reality and auditory stimulation on balance and gait abilities in persons with stroke.

BACKGROUND: Robot-assisted gait training provide a big therapeutic advantage in functional mobility for postural control. OBJECTIVES: The purpose of this study was investigate the effects of robot-assisted gait training using virtual reality and auditory stimulation on balance and gait abilities in stroke patients. METHODS: All subjects were randomly divided into three groups where twelve subjects were in the Virtual reality robot-assisted gait training group (VRGT), twelve subjects in the auditory stimulation robot-assisted gait training group (ARGT), and sixteen subjects in the control group. Subjects received virtual reality and auditory stimulation while undergoing robot-assisted gait training for 45 minutes, three times a week for 6 weeks, and all subjects had undergone general physical therapy for 30 minutes, five times a week for 6 weeks. All subjects were assessed with the Medical Research Council (MRC), Berg balance scale (BBS), timed up and go test (TUG), 10-meter walk test (10MWT), Fugl-Myer Assessment (FMA) and Modified Barthel Index (MBI) pre- and post-intervention. RESULTS: Results showed that BBS, TUG, and 10MWT scores significantly improved post-intervention (p < 0.05), and the control group also had significantly improved in all areas post-treatment (p < 0.05). In addition, it has been confirmed that VRGT had significantly improved in MRC and FMA scores compared with the auditory stimulation. Also, it has significantly improved in MRC, BBS, TUG, 10MWT and FMA compared with control group (p < 0.05). CONCLUSIONS: The results of this study showed improve balance and gait abilities after VRGT compared with general physical therapy and were found to be effective in enhancing the functional activity of persons with stroke.

Influence of visual feedback and rhythmic auditory cue on walking of chronic stroke patient induced by treadmill walking in real-time basis.

BACKGROUND: Many patients who have suffered from a stroke show decreased walking ability, characterized by asymmetric gait. For such patients, the recovery of symmetry in walking is important. OBJECTIVES: The purpose of this study is to investigate the effect of visual feedback with rhythmic auditory cue on treadmill gait in persons with chronic stroke. METHODS: Seventeen chronic subjects who have been diagnosed at least six months or before were recruited in G Hospital, located in Incheon. The subjects who were enrolled in this study were instructed to walk randomly on a treadmill: treadmill with visual feedback and rhythmic auditory cue (VF+RAC), treadmill with visual feedback (VF), general treadmill (Control; non-feedback). Three factors were observed and estimated: paretic step length, non-paretic step length, spatial asymmetry ratio at comfortable speed. Also, in VF and VF+RAC, calibration of feedback accuracy was measured. RESULTS: Results showed that paretic step length and spatial asymmetry ratio were significantly improved in VF+RAC compared to that of the VF and control (p < 0.05). Accuracies of paretic and non-paretic leg were significantly increased in VF+RAC than that of the VF (p < 0.05). CONCLUSIONS: According to this result, it seems that application of VF+RAC in treadmill gait significantly improved gait of these patients. Also, we can conclude that VF+RAC in treadmill gait is thought to be useful in clinical settings where there are many chronic patients who are in need of improvement in their gait ability.

Structural, Spectroscopic, and Theoretical Investigation of a T-Shaped [Fe3(µ3-O)] Cluster.

The synthesis, X-ray crystal and electronic structures of [Fe3(µ3-O)(mpmae)2(OAc)2 Cl3], 1, where mpmae-H = 2-(N-methyl-N-((pyridine-2-yl)methyl)amino)ethanol, are described. This cluster comprises three high-spin ferric ions and exhibits a T-shaped site topology. Variable-frequency electron paramagnetic resonance measurements performed on single crystals of 1 demonstrate a total spin ST = 5/2 ground state, characterized by a small, negative, and nearly axial zero-field splitting tensor D = -0.49 cm-1, E/D ≈ 0.055. Analysis of magnetic susceptibility, magnetization, and magneto-structural correlations further corroborate the presence of a sextet ground-spin state. The observed ground state originates from the strong anti-ferromagnetic interaction of two iron(III) spins, with J = 115(5) cm-1, that, in turn, are only weakly coupled to the spin of the third site, with j = 7(1) cm-1. These exchange interactions lead to a ground state with magnetic properties that are essentially entirely determined by the weakly coupled site. The contributions of the individual spins to the total ground state of the cluster were monitored using variable-field 57Fe Mössbauer spectroscopy. Field-dependent spectra reveal that, while one of the iron sites exhibits a large negative internal field, typical of ferric ions, the other two sites exhibit small, but not null, negative and positive internal fields. A theoretical analysis reveals that these small internal fields originate from the mixing of the lowest ST = 5/2 excited state into the ground state which, in turn, is induced by a minute structural distortion.

The effects of electromyography-triggered electrical stimulation on shoulder subluxation, muscle activation, pain, and function in persons with stroke: A pilot study.

OBJECTIVES: The purpose of this study was to examine the effects of task-oriented electromyography-triggered stimulation for shoulder subluxation, muscle activation, pain and upper extremity function in hemiparetic stroke patients. METHODS: Twenty participants with subacute hemiparetic stroke were recruited for this study and were randomly divided into two groups: experimental group (n = 10) and control group (n = 10). Subjects in the experimental group participated in task-oriented electromyography triggered stimulation for 30 minutes, five times a week for four weeks, whereas the control group received cyclic functional electrical stimulation for 30 minutes, five times a week for four weeks. Subjects in both groups received conventional physical therapy for four weeks (30 min/day, five times/week). Data collected included the degree of shoulder subluxation which had been confirmed by X-ray, muscle activation of the supraspinatus and posterior deltoid muscles by electromyography, pain by the Visual Analogue Scale (VAS), and hand function by the Fugl-Meyer Assessment (FMA) before and after the four week exercise period. RESULTS: The results showed significant improvement in shoulder subluxation, muscle activation, and VAS results in the experimental group, compared with the control group(p < 0.05). FMA scores showed no significant differences between the two groups. CONCLUSIONS: In conclusion, task-oriented electromyography-triggered stimulation improved shoulder subluxation, muscle activation, pain and upper extremity function. These results suggest that task-oriented electromyography-triggered stimulation is effective and beneficial for individuals with subacute stroke, and that further studies should be conducted on multivarious anatomical regions.

The effects of performing a one-legged bridge with hip abduction and use of a sling on trunk and lower extremity muscle activation in healthy adults.

[Purpose] This study investigated the changes in the muscle activities of the trunk and lower limbs of healthy adults during a one-legged bridge exercise using a sling, and with the addition of hip abduction. [Subjects and Methods] Twenty-seven healthy individuals participated in this study (14 males and 13 females). The participants were instructed to perform the bridge exercises under five different conditions. Trunk and lower limb muscle activation of the erector spinae (ES), external oblique (EO), gluteus maximus (GM), and biceps femoris (BF) was measured using surface electromyography. Data analysis was performed using the mean scores of three trials performed under each condition. [Results] There was a significant increase in bilateral EO and contralateral GM with the one-legged bridge compared with the one-legged bridge with sling exercise. Muscle activation of the ipsilateral GM and BF was significantly less during the one-legged bridge exercise compared to the one-legged bridge with sling exercise, and was significantly greater during the one-legged bridge with hip abduction compared to the one-legged bridge exercise. The muscle activation of the contralateral GM and BF was significantly greater with the one-legged bridge with hip abduction compared to the general bridge exercise. [Conclusion] With the one-legged bridge with hip abduction, the ipsilateral EO, GM and BF muscle activities were significantly greater than those of the one-legged bridge exercise. The muscle activation of all trunk and contralateral lower extremity muscles increased with the bridge with sling exercises compared with general bridge exercises.

Effects of scapular stabilization exercise on neck posture and muscle activation in individuals with neck pain and forward head posture.

[Purpose] The purpose of this study was to investigate the effects of scapular stabilization exercise on neck posture, muscle activity, pain, and quality of life in individuals with neck pain and forward head posture. [Subjects and Methods] Fifteen participants were recruited according to the selection criteria and were randomly allocated to the scapular stabilization group (n=8) and the control group (n=7). The scapular stabilization group underwent training for 30 minutes a day, 3 times a week for 4 weeks; the control group performed relaxation exercises for 4 weeks. [Results] After training the scapular stabilization group showed significant improvement on the craniovertebral angle, upper trapezius muscle activity, serratus anterior muscle activity, Neck Disability Index scores, Visual Analog Scale scores, and World Health Organization Quality of Life Assessment-BREF scores compared to those in the control group. [Conclusion] Scapular stabilization exercise can help improve the head posture and pain in the patients with neck pain and forward head posture. Controlling the muscular activities through scapular stabilization exercise also improves the patients' quality of life.

Effects of the height of shoe heels on muscle activation of cervical and lumbar spine in healthy women.

[Purpose] The purpose of this study was to investigate the effects of different height of high heels on muscle activation of the paraspinalis cervicis and erector spinae in healthy young women. [Subjects and Methods] Thirteen healthy women were recruited in this study. To examine the effects of different heights of heels on muscle activation, the paraspinalis cervicis (cervical spine) and erector spinae (lumbar spine) were measured at the time of heel strike and toe off during gait on three different conditions (barefoot, 4 cm high heels, and 10 cm high heels). There are no previous trials or reports that have evaluated this approach in patients with chronic neck pain. [Results] A significant increase in muscle activation of the paraspinalis cervicis and erector spinae at heel strike and toe off (except that of the paraspinalis cervicis at toe off in healthy subjects) was observed in the under 10 cm high heel condition as, compared to that with barefoot condition, in all the subjects. [Conclusion] The height of the high heels affects to the activation demand of the paraspinalis cervicis and erector spinae in patients with neck pain.

Treadmill Training with Virtual Reality Improves Gait, Balance, and Muscle Strength in Children with Cerebral Palsy.

Independent walking is an important goal of clinical and community-based rehabilitation for children with cerebral palsy (CP). Virtual reality-based rehabilitation therapy is effective in motivating children with CP. This study investigated the effects of treadmill training with virtual reality on gait, balance, muscular strength, and gross motor function in children with CP. Eighteen children with spastic CP were randomly divided into the virtual reality treadmill training (VRTT) group (9 subjects, mean age, 10.2 years) and treadmill training (TT) group (9 subjects, mean age, 9.4 years). The groups performed their respective programs as well as conventional physical therapy 3 times/week for 8 weeks. Muscle strength was assessed using a digitalized manual muscle tester. Gross motor function was assessed using the Gross Motor Functional Measure (GMFM). Balance was assessed using the Pediatric Balance Scale (PBS). Gait speed was assessed using the 10-meter walk test (10MWT), and gait endurance was assessed using the 2-minute walk test (2MWT). After training, gait and balance was improved in the VRTT compared to the TT group (P < 0.05). Muscular strength was significantly greater in the VRTT group than the TT group, except for right hamstring strength. The improvements in GMFM (standing) and PBS scores were greater in the VRTT group than the TT group (P < 0.05). Furthermore, the VRTT group showed the higher values of 10MWT and 2MWT compared to the TT group (P < 0.05). In conclusion, VRTT programs are effective for improving gait, balance, muscular strength, and gross motor function in children with CP.

Maximal lateral reaching distance on the affected side using the multi-directional reach test in persons with stroke.

[Purpose] This study aimed to examine the relationship between maximal lateral reaching distance on the affected side and weight shifting using the Multi-directional Reach Test in persons with stoke. [Subjects] Fifty-one chronic stroke participants were recruited from two rehabilitation hospitals. This study administered the Berg Balance Scale, Timed Up-and-Go, Trunk Impairment Scale, Modified Barthel Index and measured different maximal reaching distances. [Results] The maximal lateral reaching distance on the affected side was correlated with the BBS (r=0.571), TUG (r=-0.478), TIS (r=0.561), and MBI scores (r=0.499), the lateral reaching distance in all directions on the non-affected side (r=0.785), the maximal backward reaching distance (r=0.723), and the maximal forward reaching distance (r=0.673). The maximal reaching distance on the affected side was also affected by that on the non-affected side, in addition to the maximal backward reaching distance and MBI score. The final step model of stepwise multiple regression was explained 69.5%. [Conclusion] Maximal lateral reaching distance on the affected side as determined by the Multi-directional Reach Test is a good method of assessing functional performance in stroke patients. Data regarding maximal reaching distance on the non-affected side can be used to measure functional impairment on the affected side in clinical settings.

Test-retest reliability of the Quebec user evaluation of satisfaction with assistive technology 2.0-Korean version for individuals with spinal cord injury.

[Purpose] The study purpose was to investigate the test-retest reliability of the Quebec User Evaluation of Satisfaction with assistive Technology 2.0-Korean version (QUEST-K) for individuals with traumatic spinal cord injury. [Subjects and Methods] Seventy participants with spinal cord injury were enrolled in this study. The participants were assessed using the QUEST-K in two sessions conducted 3 days apart. This study also utilized the spinal cord independence measure III and modified Barthel index for determining their validity concurrently with the QUEST-K. [Results] The test-retest reliability (intraclass correlation coefficient 0.855) of the QUEST-K was high, indicating a good agreement. The results of the QUEST-K testing were not substantially positively correlated with those of the spinal cord independence measure III (r = -0.075) and Modified Barthel Index (r=-0.138). [Conclusion] The test-retest reliability of the QUEST-K was high in individuals with spinal cord injury. The QUEST-K could be a reliable measure for evaluating the satisfaction with assistive technology during functional performance in patients with spinal cord injury. The ability of the QUEST-K to detect actual changes is acceptable for research and clinical settings.

The effect of foot position on erector spinae and gluteus maximus muscle activation during sit-to-stand performed by chronic stroke patients.

[Purpose] The aim of this study was to use surface electromyography (EMG) to investigate the effects of different foot positioning on bilateral erector spinae (ES) and gluteus maximus (GM) activation during sit-to-stand performed by individuals with stroke. [Subjects] Fifteen randomly selected participants with stroke were enrolled in this study. [Methods] All the participants were asked to perform sit-to-stand (STS) using three different strategies: (1) symmetric foot position, (2) unaffected foot placed behind the affected foot position (asymmetric-1), (3) affected foot placed behind the unaffected foot position (asymmetric-2). An EMG system was used to measure ES and GM muscle activities. The strategies were performed in a random order, and the mean values of five measurements were used in the analysis. One-way repeated measure ANOVA was used to determine the statistical significance of differences between the conditions. [Results] The affected ES muscle activity was significantly greater in asymmetric-2 (180.7±73.4) than in symmetrical foot placement (149.8±54.2). In addition, the affected ES, unaffected ES, and affected GM muscle activity were significantly greater in asymmetric-2 (180.7±73.4, 173.5±83.1, 98.3±90.3 respectively) than in asymmetric-1 foot placement (147.3±53.8, 151.2±76.5, 84.9±73.8 respectively). [Conclusion] Our results suggest that it may be more desirable for persons with stroke to place the affected foot behind the unaffected foot when performing STS to increase affected ES and GM muscle activation.

Treadmill gait training combined with functional electrical stimulation on hip abductor and ankle dorsiflexor muscles for chronic hemiparesis.

The purpose of this study was to investigate the effects of treadmill training (TT) with functional electrical stimulation (FES) applied to the gluteus medius (GM) and tibialis anterior (TA) muscles on gait and balance performance in individuals with chronic hemiparetic stroke. Thirty-six participants with chronic hemiparesis were recruited to this study and randomly distributed into three groups: TT with FES applied to the GM and TA muscles (TTFES-GM+TA group, 12 patients); TT with FES applied to the TA muscle (TTFES-TA group, 12 patients); and TT only (control group, 12 patients). All participants underwent 20 sessions of TT with a harness (30min five times per week for 4 weeks). They also received regular physical therapy for 1h five times per week for 4 weeks. All participants were assessed before and after training using digital muscle testing, the Medical Research Council (MRC) scale, the 6-min walk test (6MWT), and spatiotemporal parameters. After training, the TTFES-GM+TA group showed significant improvement in hip abductor strength, Berg Balance Scale score, 6MWT result, MRC scale score grade, gait velocity, and cadence compared to the TTFES-TA group and control group. These findings show that TT with FES applied to the GM and TA muscles increased lower limb muscle strength and improved balance and gait capacities. Therefore, TT with FES applied to the GM and TA could be a beneficial intervention in clinical settings for individuals with chronic hemiparetic stroke.

Effects of gait training with a cane and an augmented pressure sensor for enhancement of weight bearing over the affected lower limb in patients with stroke: a randomized controlled pilot study.

OBJECTIVE: The purpose of this study was to examine the effect of gait training when using a cane with an augmented pressure sensor for enhancement of weight-bearing over the affected lower limb on the peak pressure force of the cane, muscle activation, and gait in patients with stroke. DESIGN: Randomized controlled pilot study. SETTING: Inpatient rehabilitation center. PARTICIPANTS: A total of 22 hemiparetic stroke patients were recruited and randomly divided into an experimental group (n = 11) and control group, which later had a drop-out (n = 10). INTERVENTIONS: Subjects in the experimental group participated in gait training with auditory feedback for 30 minutes, five times a week for four weeks, whereas those in the control group received gait training without auditory feedback for the same amount of time. MAIN MEASURES: The peak force of cane, muscle activation of gluteus medius, and vastus medialis oblique, single limb support phase of the affected leg, and gait speed before and after training were collected. RESULTS: Significant improvement in the peak force of cane, muscle activation of gluteus medius and vastus medialis oblique, single limb support phase of the affected leg, and gait speed were observed in the experimental group (13.5 ±9.5 cm/s) compared with the control group (3.7 ±8.4 cm/s) (p < 0.05). CONCLUSION: Gait training using a cane with an augmented pressure sensor to enhance weight bearing over the affected lower limb is beneficial and effective in improving the peak force of cane, muscle activation, and gait in stroke patients.

Intensive gait training with rhythmic auditory stimulation in individuals with chronic hemiparetic stroke: a pilot randomized controlled study.

BACKGROUND: Motor relearning protocols should involve task-oriented movement, focused attention, and repetition of desired movements. OBJECTIVES: To investigate the effect of intensive gait training with rhythmic auditory stimulation on postural control and gait performance in individuals with chronic hemiparetic stroke. METHODS: Twenty patients with chronic hemiparetic stroke participated in this study. Subjects in the Rhythmic auditory stimulation training group (10 subjects) underwent intensive gait training with rhythmic auditory stimulation for a period of 6 weeks (30 min/day, five days/week), while those in the control group (10 subjects) underwent intensive gait training for the same duration. Two clinical measures, Berg balance scale and stroke specific quality of life scale, and a 2-demensional gait analysis system, were used as outcome measure. To provide rhythmic auditory stimulation during gait training, the MIDI Cuebase musical instrument digital interface program and a KM Player version 3.3 was utilized for this study. RESULTS: Intensive gait training with rhythmic auditory stimulation resulted in significant improvement in scores on the Berg balance scale, gait velocity, cadence, stride length and double support period in affected side, and stroke specific quality of life scale compared with the control group after training. CONCLUSIONS: Findings of this study suggest that intensive gait training with rhythmic auditory stimulation improves balance and gait performance as well as quality of life, in individuals with chronic hemiparetic stroke.

Therapeutic effect of functional electrical stimulation-triggered gait training corresponding gait cycle for stroke.

The purpose of this study was to determine the therapeutic effects of functional electrical stimulation (FES) applied to the gluteus medius and tibialis anterior muscles during the gait cycle in individuals with hemiparetic stroke. Eighteen patients who had suffered a stroke were enrolled in this study. The participants were divided into either the gluteus medius and tibialis anterior (GM + TA) training group (n = 9) or the control group (n = 9). The GM + TA group received FES-triggered gait training to the gluteus medius (GM) in the stance phase and the tibialis anterior (TA) in the swing phase for 30 min, 5 session a week over a 6-week period, and control group who received only gait training without FES-triggered for the same duration of time. A foot-switch sensor was used to trigger the device in the stance (GM) and swing (TA) phases of the gait cycle reciprocally. This study measured three types of outcome measures, including spatiotemporal gait parameters, muscles activities, and balance function. After 6 weeks training, there was a significant improvement in gait velocity, cadence, stride length, and gait symmetry in the GM + TA training group compared to the control group. Dynamic balance function was significantly improved in the GM + TA training group compared to the control group. The mean changeable values of the GM was significantly greater strength in the GM + TA training group than the control group. These findings suggest that FES-triggered gait training of the GM in the stance phase and TA in the swing phase may improve the spatiotemporal parameters of gait in persons with hemiparetic stroke.

Immediate effects of rhythmic auditory stimulation with tempo changes on gait in stroke patients.

[Purpose] The aim of this study was to investigate the effects of tempo changes in rhythmic auditory stimulation (RAS) on gait in stroke patients. [Subjects] Forty-one chronic stroke patients who had had a stroke with more than 6 months previously were recruited for this study. [Methods] All participants were asked to walk under 5 different conditions in random order: (1) no RAS (baseline); (2) baseline-matched RAS (0%); and (3) -10%, (4) +10%, and (5) +20% of the baseline. A GAITRite system was used to evaluate the spatial and temporal parameters of gait. [Results] Compared with under the RAS 0% conditions, the gait velocity, cadence, and stride length on the affected side were significantly decreased under the RAS -10% conditions. Gait velocity and cadence were significantly improved, but gait symmetry was significantly decreased under the RAS +10% and +20% conditions compared with under the RAS 0% conditions. [Conclusion] A faster RAS tempo significantly improved gait velocity and cadence, and applying RAS significantly improved the gait symmetry of stroke patients.