title: Efficacy of an insole shoe wedge and augmented pressure sensor for gait training in individuals with stroke: a randomized controlled trial.
abstract: OBJECTIVE
  To determine whether external feedback to promote symmetrical weight distribution during standing and walking would improve gait performance and balance in people with stroke.
  
  
  METHODS
  Randomized, controlled, assessor-blinded trial.
  
  
  METHODS
  Rehabilitation unit and physical therapy department.
  
  
  METHODS
  Thirty-five individuals with stroke (mean (SD) age = 53.0 (9.3) years) were randomly assigned to an experimental (n = 17) or control group (n = 18). Time post stroke was less than six months for most subjects (n = 27, 77%).
  
  
  METHODS
  Subjects participated in 15 rehabilitation sessions including 30 minutes of gait retraining per session. During gait retraining, the experimental group used an insole shoe wedge and sensors set-up (I-ShoWS) while the control group received a conventional programme. The I-ShoWS set-up consisted of a wedge insole and a footswitch for the non-paretic leg and a pressure sensor on the paretic leg.
  
  
  METHODS
  Gait speed, step length and single support time asymmetry ratio, balance and amount of load on paretic leg during stance were evaluated twice: one day before and after training.
  
  
  RESULTS
  The experimental group demonstrated significant increase in standing and gait symmetry compared with the control group (P < 0.05). They demonstrated 3 times greater improvement in gait speed than the control group (P = 0.02). Balance improvement was significantly greater for the experimental than for the control group (P < 0.05).
  
  
  CONCLUSIONS
  Gait retraining using the I-ShoWS set-up was more effective in restoration of gait speed, standing and walking symmetry and balance than a conventional treatment programme. These results indicate the benefit of implementing feedback during gait retraining.
authors.affiliation: Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand. onlaor@chiangmai.ac.th
authors.forename: Somporn
authors.initials: S
authors.lastname: Sungkarat
authors.forename: Beth E
authors.initials: BE
authors.lastname: Fisher
authors.forename: Apichana
authors.initials: A
authors.lastname: Kovindha
mesh_terms: D056228:Feedback, Sensory; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D012775:Shoes; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation