Walking Training with a Weight Support Feedback Cane Improves Lower Limb Muscle Activity and Gait Ability in Patients with Chronic Stroke: A Randomized Controlled Trial

BACKGROUND: Induction of proper weight transfer to the affected lower limb should be considered the most essential factor for successful stroke cane gait training. This study aimed to investigate the effect of walking training with a weight support feedback cane on lower limb muscle activity and gait ability of chronic stroke patients. MATERIAL/METHODS: Thirty stroke patients were randomized into 2 groups: a weight support feedback cane gait training group (WSFC group, n=15) and a conventional cane gait training group (CC group, n=15). All subjects were enrolled in standard rehabilitation programs for 4 weeks. Additionally, the WSFC group participated in WSFC gait training and the CC group participated in conventional cane gait training for 4 weeks. During WSFC gait training, the weight support rate loaded on the cane was reduced by 10% every week from 60% to 30% based on the measured initial cane dependence, while the CC group participated in conventional cane gait training with verbal instruction to reduce cane dependence. Lower limb muscle activity and gait ability were measured using wireless surface electromyography and a 3-axis accelerometer during walking. RESULTS: The WSFC group showed significantly greater improvement than the CC group in lower limb muscle activity and gait ability (P<0.05). CONCLUSIONS: Cane gait training significantly improved lower limb muscle activity and gait ability in stroke regardless of the training method; however, the addition of real-time weight support feedback to cane gait training appears to provide further benefit compared with conventional cane gait training in chronic stroke patients.