Using swing resistance and assistance to improve gait symmetry in individuals post-stroke

A major characteristic of hemiplegic gait observed in individuals post-stroke is spatial and temporal asymmetry, which may increase energy expenditure and the risk of falls. The purpose of this study was to examine the effects of swing resistance/assistance applied to the affected leg on gait symmetry in individuals post-stroke. We recruited 10 subjects with chronic stroke who demonstrated a shorter step length with their affected leg in comparison to the non-affected leg during walking. They participated in two test sessions for swing resistance and swing assistance, respectively. During the adaptation period, subjects counteracted the step length deviation caused by the applied swing resistance force, resulting in an aftereffect consisting of improved step length symmetry during the post-adaptation period. In contrast, subjects did not counteract step length deviation caused by swing assistance during adaptation period and produced no aftereffect during the post-adaptation period. Locomotor training with swing resistance applied to the affected leg may improve step length symmetry through error-based learning. Swing assistance reduces errors in step length during stepping; however, it is unclear whether this approach would improve step length symmetry. Results from this study may be used to develop training paradigms for improving gait symmetry of stroke survivors.