Immediate changes in post-stroke gait using a shoe lift on the nonaffected lower limb: A preliminary study

ABSTRACT

Introduction: Gait impairment is one of the most important post-stroke complications and is associated with reduced mobility, limitations in activities of daily living and decreased quality of life. Gait recovery is an important goal in post-stroke rehabilitation and shoe lifts have been used on the nonaffected lower limb (NLL) to reduce compensatory strategies such as vaulting, pelvic hiking and hip circumduction during the swing phase of the affected lower limb. Moreover, in clinical practice shoe lifts seem to reduce tripping and the risk of falls.

Objective: Evaluate walking speed and functional mobility with and without a 1.5 cm shoe lift under the non-affected lower limb in post-stroke gait.

Methods: Forty-two subjects with hemiparesis after stroke were evaluated on a single day, under two conditions: with and without a 1.5 cm shoe lift. The assessment sequence was randomized and clinical tests (Ten-meter walk Test – 10MWT and Timed Up and Go – TUG) were performed one after the other.

Results: There was a significant increase in walking speed in the 10MWT and shorter TUG times, with mean differences of 0.78 (CI95% 0.15–1.41, P ≤ 0.001, EF = 0.55) and 0.57 seconds (−0.11–1.25, P = .022, EF = 0.35), respectively.

Conclusion: The results showed that the immediate use of 1.5 cm shoe lifts seems to improve gait speed and functional mobility in chronic stroke patients. Further studies should focus on understanding the kinematics strategies and gait pattern alterations caused by shoe lifts under the NLL of post-stroke individuals.

KEYWORDS:

• Stroke
• gait
• hemiparesis
• orthotic devices

Declaration of interest

The authors declare no conflict of interest.