The Immediate Effect of a Textured Insole in Nonparetic Lower Limb Symmetry of Weight Bearing and Gait Parameters in Patients with Chronic Stroke

Abstract

Objective Weight-bearing asymmetry is one of the main causes of balance disturbances in patients with\rhemiparesis and could cause standing problems and gait abnormalities for them. The purpose of this\rstudy was to investigate the immediate effects of wearing unilateral textured insoles on the symmetry of\rweight bearing during standing and gait parameters of patients with chronic stroke.\rMaterials & Methods In this quasi-experimental study, 16 patients with hemiparesis were selected by\rsimple non-probability sampling method. These patients had an average age(SD) of 52.12(6.94) years\rand their average(SD) post-injury duration was 33.12(16.4) months. Symmetry index during standing\rposition (by using 2 equal weighting scales), step length symmetry, step length, and walking velocity (by\rusing NeuroCom Balance Master Device) was measured in 3 conditions: without insole (barefoot), wearing\rtextured insole with shore A-80 hardness, and textured insole with shore A-60 hardness.\rResults In this study, we conducted the multivariate analysis of variance for comparing 3 test conditions\rand Bonferroni test for paired comparing. The symmetry of step length showed a significant difference\rbetween no insole condition and using insole with A-80 hardness (P=0.004), as well as using A-80 hardness\rinsole with A-60 hardness insole (P=0.011). However, there was no significant difference between\rusing no insole and using insole with A-60 hardness (P=0.325). The results of symmetry index likened\rthe step length results. This means that there was a significant difference between not using insole and\rwearing insole with A-80 hardness (P=0.022), also between the results of wearing 2 different insoles\r(P=0.019). However, no significant difference was observed between using no insole and using insole\rwith A-60 hardness in spite of improvement in step length (P=0.325). Velocity of walking and step length\rwas not meaningfully improved in any of the conditions.\rConclusion The current study showed that obligatory use of affected limb side could improve symmetry\rof weight bearing in walking and standing position of patients with chronic stroke by overcoming the\rphenomenon of learned lack of using and correcting the failure of sending sensory signals to centers of\rmovement controls. The results of this study showed that unilateral use of textured insole with shore\rA-80 in the unaffected side could immediately improve weight bearing symmetry and step length symmetry\rin patients with hemiparesis, but it has no effect on their walking speed and step length. Using\rinsole with A-60 hardness did not significantly change any variables of tests. Considering the results of\rthis study, these insoles can be used in balance exercises and walking of hemiparetic patients.