This study aimed to investigate whether elastic band-assisted knee flexion during gait training would improve gait characteristics and dynamic balance in individuals with stroke.
Ten participants with chronic hemiplegia following stroke (ages 45-70: 10-20 months post stroke) were recruited. This study was an A1-B-A2 design spanning nine weeks, each phase lasting three weeks. The elastic band was placed on each participant's affected leg so that the tension from the band promoted knee flexion during the swing phase of gait. Each time, the band was wrapped in the same pattern around the affected lower extremity. The middle of the elastic band wrapped around the midfoot and crossed anteriorly over the top of the ankle with about five inches of tension applied. It was then brought posteriorly and crossed again around the back of the lower leg. Finally, both ends were pulled anteriorly, with another 10 inches of tension applied and tied to a gait belt. Each participant walked with an elastic band for 15 mins, 3 times a week during phases A1 and A2, while during phase B they did normal daily activities. Gait parameters, including step length, stride length, step time, step time differential, and gait velocity, were measured using GAITrite. Balance during movement was assessed using the Timed-Up and Go (TUG) test. All parameters were measured before the start and at the end of the A1, B, and A2 phases. The means and standard deviations (SD) were calculated from eight trials. Changes were significant when the mean difference is beyond + 2SD.
At the end of phase A1, step length, stride length, and gait velocity were increased significantly, while step time, step time differential, and TUG scores reduced significantly. Changes in step length and TUG scores in six participants exceeded their MCID values. At the end of phase B, no significant changes were observed in either gait characteristics or TUG scores compared to the values obtained at the start of phase B except for a substantial decrease in gait velocity in one participant. At the end of phase A2, six participants showed significant increases in step length, stride length, and gait velocity and decreased time to complete TUG when compared to the values at the end of phase B. Changes in step length and gait velocity in all six participants were beyond the MCID values.
Based on our results, we have concluded that the facilitation of knee flexion during the swing phase of gait using an elastic band would be another intervention technique to improve gait and balance in individuals with stroke.
Our results clearly indicate that gait training with elastic band-assisted knee flexion might be an option for physical therapists to improve the gait characteristics and balance in individuals with chronic stroke.
Gait
Balance
