Effects of weight-shift training on walking ability, ambulation, and weight distribution in individuals with chronic stroke: a pilot study.

BACKGROUND: People with gait difficulties after a stroke usually have an asymmetrical gait and slower gait speed than age-matched controls. These difficulties restrict people with stroke in their daily life activities.

OBJECTIVE: This pilot study sought to evaluate the effects of weight-shift training on gait, weight distribution in standing, and ambulation in people with gait difficulties after a stroke.

METHODS: Ten subjects with chronic stroke (3-11 years since insult) and remaining gait difficulties participated in a 3-week weight-shift training program. Spatial and temporal gait parameters were assessed pre-, post-, and 3-month post-training with a motion analysis system. Weight distribution was assessed with force plates and ambulation with the Swedish version of the Clinical Outcome Variables Scale (S-COVS). Wilcoxon signed-rank tests were used to explore differences between test occasions.

RESULTS: Significant changes were seen between pre-and post-tests in decreased stance time on the non-paretic leg (P = 0.005) and increased score on the S-COVS (P = 0.043). At the 3-month follow-up test, the subjects had also increased their gait speed significantly (P = 0.037). Standing weight distribution did not change between pre- and post-tests (P = 0.575), but between the pre-and follow-up tests it shifted from the paretic leg to the non-paretic (P = 0.007).

CONCLUSION: Weight-shift training seems to improve gait and ambulation in subjects with chronic stroke, but not with standing weight distribution. However, this pilot study has several limitations and a larger sample size with a control group is necessary.