Effects of Multi-direction Stepping and Weight Shifting Exercises in Stroke Patients

Effects of Multi-direction Stepping and Weight Shifting Exercises on Balance and Gait in Stroke Patients

Stoke is a leading cause of disability that results not only in persistent neurological deficits but also profound physical de-conditioning that propagates stroke-related secondary disability. Several kinds of research have reported that there has been asymmetrical weight bearing on the affected side while sitting and standing resulting in impaired performance especially reaching in sitting, rising from the chair, walking, and climbing stairs. Despite the stroke patient being able to walk independently with or without the walking aids, the patient still lacks the normal movement pattern especially weight transfers on the affected side while performing such activities which subsequently decreases the patient to restrain the challenges while walking, decrease confidence in functional activities. Also, further, there hasn't been enough literature on this topic. Therefore, the objective of this study is to find out the effectiveness of multidirectional stepping and weight shifting exercises to improve dynamic balance and gait speed in stroke patients.

The twenty-four subjects who fulfilled the inclusion criteria were selected for the study and were randomly assigned into two groups of 12 subjects each by simple random sampling based on inclusion criteria. First, all the subjects were assessed with a detailed neurological assessment form after the consent form was taken from the patients. The experimental group was given multidirectional stepping exercise with conventional therapy whereas are control group was given only conventional therapy.

Inclusion Criteria:

• Diagnosed with stroke via CT Scan or MRI
• Maintain the independent standing posture for 30 sec
• Ability to walk 3 meters independently without an assistive device
• Mini-Mental status examination score >21 points
• Could communicate and understand therapist's verbal command
• Voluntary agreed to participate in the study
• Age above 18 years old
• Medically stable (e.g. recent myocardial infarction, unstable angina, ventricular tachycardia)

Exclusion Criteria:

• Visual disorders and visual deficits
• History of any neurological pathology like Parkinson's or Alzheimer's disease
• Conditions affecting balance like vertigo
• Medications affecting balance
• Dementia
• Impaired conscious level or concomitant medical illness
• Lower Motor Neuron lesions
• Anti-spasmodic medication (e.g. Baclofen, Dantrolene Sodium, etc.)
• Severe orthopedic diseases in lower extremities (e.g. Osteoarthritis, fracture, sprain, strain)