Abstract
Background: Ankle dysfunction in stroke patients is a common but serious cause of balance and gait impairment. However there seldom exists comprehensive paretic ankle training. Thus we investigated the effects of biaxial ankle muscle training (AMT) using visual feedback as a means to improve ankle strength and functional activities in stroke patients. Methods: The study design was a randomized controlled pilot trial with concealed allocation and assessor blinding, and intention-to-treat analysis. Twenty-five patients with stroke under inpatient rehabilitation with difficulty walking (e.g. foot drop), or ankle muscle weakness participated. The experimental group underwent AMT consisting of passive stretching, contraction to match movement, and active-resistive strengthening using visual feedback for 40 minutes per day, 5 times per week for 4 weeks. The control group underwent ankle-related physical therapy including ankle range of motion(ROM) exercises for matched time period. The outcomes were ankle isometric contraction force, Fugl-Meyer lower extremity (FM-L), Berg balance scale (BBS), walking speed, and ankle co-contraction index (CI) during gai. Results: The results showed significant between-group differences for ankle isometric contraction in each direction (P<0.05), FM-L (P<0.01) and stance-phase CI (P<0.05). Post training, the AMT group displayed significant differences in the ankle isometric contraction in each direction (P<0.01), ankle proprioception (P<0.05), and walking speed (P<0.05). Conclusions: Our findings demonstrate the significant short-term effects of AMT on ankle strength, walking speed, and ankle muscle efficiency in chronic stroke survivors.
Effect of Spinal Stabilization with Visual Feedback on the Balance of Chronic Stroke Patients
