Standing balance training: effect on balance and locomotion in hemiparetic adults

The effects of balance retraining on standing balance and locomotor performance were examined in postacute hemiparetic adults. Balance during habitual and instructed-even standing, as well as locomotor performance, were measured before and after a three- to four-week treatment period. Two groups of 21 matched subjects participated in physical therapy. One group received standing balance training with a specially designed feedback device that provided dynamic visual information about relative weight distribution over the paretic and nonparetic limb. Subjects trained with the feedback device showed significantly better static standing symmetry than did subjects who did not receive augmented feedback, p less than .05. Although both groups improved significantly in gait velocity, cadence, stride length, and cycle time, p less than .01, the initially identified asymmetrical locomotor pattern appeared to be only minimally affected by the standing balance training. Results indicated that although standing balance and locomotor control mechanisms may be highly interrelated, a reduction in standing balance asymmetry does not necessarily lead to a concomitant reduction in the asymmetrical limb movement patterns associated with hemiparetic locomotion.