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Critical Reviews™ in Physical and Rehabilitation Medicine

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ISSN Imprimir: 0896-2960

ISSN On-line: 2162-6553

SJR: 0.141 SNIP: 0.129 CiteScore™:: 0.6 H-Index: 18

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Effects of Compelled Body Weight Shift Therapy on Weight-Bearing Symmetry, Balance and Gait in Patients with Stroke: A Narrative Review

Volume 33, Edição 4, 2021, pp. 45-64
DOI: 10.1615/CritRevPhysRehabilMed.2021040265
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Alisha Austin Lobo
Postgraduate, Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
Abraham M. Joshua
Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India-575001
Akshatha Nayak
Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India

RESUMO

Background: Post-stroke patients exhibit reduced loading over the paretic lower extremity, leading to increased postural sway, balance, and gait asymmetry predisposing to falls. Achieving stance and weight-bearing symmetry are essential contributors in achieving independent ambulation. Compelled body weight shift (CBWS) uses shoe inserts under the non-paretic lower extremity forcing the individual to shift the bodyweight towards the paretic extremity. It facilitates the individuals to overcome the phenomenon of learned disuse and improves weight-bearing symmetry.
Purpose: To consolidate evidence regarding the use of CBWS training in achieving weight-bearing symmetry, improving balance, and gait in stroke patients.
Methods: A comprehensive search was conducted on five databases (PubMed, ClinicalKey, Proquest, ScienceDirect, and Cochrane databases) using predefined MeSH terms. Randomized and non-randomized controlled and clinical trials in the English language published between 2011 and 2021 were retrieved.
Result and Discussion: Studies compared the application of shoe inserts of various heights during conventional stroke rehabilitation and their effect on weight-bearing symmetry, balance, and gait. Studies revealed increased weight-bearing on the paretic lower extremity and increased balance performance. Improvement was noted in spatiotemporal parameters of gait; mainly step length, single support stance time, and gait velocity.
Conclusion: CBWS using shoe lifts and wedges of different heights under the non-paretic lower extremity during conventional stroke rehabilitation effectively improved weight-bearing symmetry. Shoe lifts were effective in improving balance and weight-bearing symmetry, whereas the use of shoe wedges led to improvements in spatiotemporal gait parameters because of the additional subtalar eversion provided by the wedge.

Palavras-chave: Stroke, CBWS, compelled body weight shift therapy, constrained weight shift training, balance, weight-bearing symmetry, gait
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