Effectiveness of Additional Structured Strength Training of Unaffected Lower Extremity on Balance and Gait Among...

Introduction: Stroke reduces lower extremity muscle strength bilaterally, predominantly on the affected side. Stroke rehabilitation focuses on training the hemiparetic extremities, whereas functional activities require the recruitment of bilateral lower extremity muscles. Objectives: This research is aimed at studying the effectiveness of additional structured strength training of unaffected lower extremity (ULE) on balance and gait among acute poststroke individuals. Methods: This Nonrandomized Controlled Trial included 28 clinically stable acute poststroke individuals aged 20-80 years, with the first episode of stroke, and who could walk 5 m with or without assistive devices. The subjects were assigned to either an experimental group (n = 14) or a control group (n = 14). Both groups received 12 sessions of conventional stroke rehabilitation focusing on the affected side. In addition, individuals in the experimental group received structured strength training for the ULE. Main Outcome Measure: Balance, gait, and muscle strength of the ULE were measured pre and after 2 weeks of intervention using Brunel Balance Assessment (BBA), Wisconsin Gait Scale (WGS), 2D gait analysis (Kinovea software), and a handheld dynamometer, respectively. Results: The strength in the ULE of the experimental group improved significantly in all the muscle groups, whereas the control group showed improvements only in hip flexors, hip extensors, knee flexors, and ankle dorsiflexors. However, the strength gains in the hip flexors, hip abductors, knee extensors, and ankle dorsiflexors were significantly greater in the experimental group. Additionally, there was a significant difference among the groups in the BBA (p = 0.001) and WGS scores (p = 0.012). The kinematic variables of gait showed better knee flexion (p = 0.006), dorsiflexion angles (p = 0.016), and gait speed (p = 0.008) in the experimental group. Conclusion: Additional structured lower extremity strengthening of the ULE led to improved strength of ULE, resulting in better balance function and gait among individuals with acute stroke. Trial Registration: ClinicalTrials.gov identifier: CTRI/2018/12/016685.