Abstract
Purpose
Paretic side collisions frequently occur in stroke patients, especially while walking through narrow spaces. We determined whether training for walking through an opening (T-WTO) while entering from the paretic side would improve collision avoidance behavior and prevent falls after 6 months.
Materials and Methods
Thirty-eight adults with moderate-to-mild hemiparetic gait after stroke who were hospitalized in a rehabilitation setting were randomly allocated to the T-WTO (n = 20) or regular rehabilitation (R-Control; n = 18) program. Both groups received five sessions of 40 min per week, for three weeks total. T-WTO included walking through openings of various widths while rotating with the paretic side in front, and R-Control involved normal walking without body rotation. Obstacle avoidance ability, 10-m walking test, timed Up and Go test, Berg Balance Scale, Activities-specific Balance Confidence, the perceptual judgment of passability, and fall incidence were assessed.
Results
Collision rate and time to passage of the opening in obstacle avoidance task significantly improved in the T-WTO group compared with those in the R-Control group. Contrast, T-WTO did not lead to significant improvements in other outcomes.
Conclusions
T-WTO improved efficiency and safety in managing subacute stroke patients. Such training could improve patient outcomes/safety because of the paretic body side during walking.
Clinical Trial Registration No.
R000038375 UMIN000033926
Implications for Rehabilitation
Individuals with stroke often collide with the paretic side while walking through narrow spaces.
Training for walking through a narrow opening from the paretic side improved an individual’s ability to avoid obstacles in similar tasks.
Moreover, such training could improve patient outcomes/safety because such interventions may temporarily increase attentional focus to the paretic side in specific tasks.
Acknowledgment
The authors would like to thank all the people who participated in the trial.
Disclosure statement
None declared.
Data availability statement
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.