Immediate augmented real-time forefoot weight bearing using visual feedback improves gait symmetry in chronic stroke

Abstract

BACKGROUND:

Symmetry of gait is an important component of rehabilitation in stroke patients. Insufficient weight-bearing causes gait asymmetry.

OBJECTIVE:

This study aimed to identify the immediate effects of sufficient weight-bearing on the forefoot during the stance phase using visual feedback.

METHODS:

Twenty-seven individuals with stroke enrolled in this study. All patients were evaluated for gait parameters with and without visual feedback. Visual feedback was provided through a smart application and a beam projector screen that showed a weight shift as a change in color. Spatiotemporal gait parameters were evaluated, resulting in values for a calculated symmetry index, in addition to heel % and toe % temporal values.

RESULTS:

Velocity and cadence were significantly decreased when visual feedback was provided ( $p<$ 0.05). Spatiotemporal parameters, except for bilateral step length, swing time of affected side, and single-limb support of less affected side, showed significant improvement ( $p<$ 0.05). The gait pattern of subjects was more symmetrical with visual feedback compared to non-visual feedback ( $p<$ 0.05). The toe-on time significantly improved on the affected side with visual feedback ( $p<$ 0.05).

CONCLUSION:

This study suggests that visual feedback aids in the improvement of gait symmetry, forefoot weight-bearing on the affected side, and spatiotemporal parameters.