The effect of progressive task-oriented training on a supplementary tilt table on lower extremity muscle strength and gait recovery in patients with hemiplegic stroke

The purpose of this study was to determine the influence of progressive task-oriented training on a supplementary tilt table on the lower extremity (LE) muscle strength and spatiotemporal parameters of gait in subjects with hemiplegic stroke. Thirty subjects between three and nine months post stroke were included in this study. Thirty subjects were randomly allocated to a control group (CG, n(1) = 10), experimental group I (EG(1), n(2) = 10), and experimental group II (EG(2), n(3) = 10). All of the subjects received routine therapy for half an hour, five times a week for three weeks and additionally received training on the following three different tilt table applications for 20 min a day: (1) both knee belts of the tilt table were fastened (CG), (2) only the affected side knee belt of the tilt table was fastened and one-leg standing training was performed using the less-affected LE (EG1), and (3) only the affected side knee belt of the tilt table was fastened and progressive task- oriented training was performed using the less- affected LE (EG2). The effect of tilt table applications was assessed using a hand- held dynamometer for LE muscle strength and GAITRite for spatiotemporal gait data. Our results showed that there was a significantly greater increase in the strength of all LE muscle groups, gait velocity, cadence, and stride length, a decrease in the double limb support period, and an improvement in gait asymmetry in subjects who underwent progressive task- oriented training on a supplementary tilt table compared to those in the other groups. These findings suggest that progressive task- oriented training on a supplementary tilt table can improve the LE muscle strength and spatiotemporal parameters of gait at an early stage of rehabilitation of subjects with hemiplegic stroke. (C) 2014 Elsevier B.V. All rights reserved.