Effects of prosthetic gait training for stroke patients to induce use of the paretic leg: a report of three cases.

During recovery from a stroke, body weight-bearing on a paretic leg is spontaneously avoided. In physiotherapy for hemiparetic gait, as long as the patients can use their non-paretic leg, adaptive and compensatory strategies are always used to support and move the body. We examined the effects of gait training using prosthetics to induce the use of a paretic leg during walking. The prosthesis was applied to the non-paretic leg of three right hemiparetic patients. Prosthetic gait training was performed until finishing 5 successive motor learning sessions involving walking over 200 m and the changes of asymmetric gait performances were analyzed. The ground reaction forces during the initial stance phase of the paretic leg were increased in all patients after prosthetic gait training. Simultaneously, the propulsive force produced by the paretic leg was increased in 2 patients. By contrast, another patient developed more use of his non-paretic leg for propulsion corresponding to acquiring stability on the paretic leg, resulting in an improvement in single-support-time asymmetry. Task-specific effects provided by prosthetic gait training may be able to reorganize the motor strategy for hemiparetic gait by inducing the use of the paretic leg to support and propell the body.