STROKE
August 31, 2012

Shoe Insert Helps Stroke Patients Regain Balance

An insole helped stroke patients regain balance and strength on their injured side. Easy and simple and amazing.

Sometimes the simplest things can start patients on the road to recovery. And for stroke patients, a simple shoe insert may do the trick. A foam shoe insole used on the unaffected side helped stroke patients improve their balance, walk faster and bear more weight on the side of the body weakened by the stroke after just two weeks.

It's simplicity itself. Raise the back of your left foot and your weight shifts to the right. Or raise the right foot and weight shifts to the left. There's no thought involved and no training needed. It all happens automatically.

Balance after a stroke is much less stable, and walking considerably more difficult than before the stroke. Continuing to stand and walk in this unbalanced fashion hampers recovery.

After a stroke, one side of the body is weakened. This causes a shift in balance, with people placing less weight on their weakened leg while standing or walking and causes them to walk with an altered gait. Balance after a stroke is much less stable, and walking considerably more difficult than before the stroke. Continuing to stand and walk in this unbalanced fashion hampers recovery. Various therapies try to teach stroke patients to compensate for the disability and rebalance their weight. The shoe insert does this automatically.

The inserts used in the study were medium-hard foam insoles made of ethylene vinyl acetate. All were the same height: 0.6 centimeters, about a quarter of an inch.

In a small study by researchers at the University of Illinois at Chicago of 11 patients who had recently suffered a stroke, five used an insole in one shoe, while the other six did not. Both groups received the same physical therapy treatments--six sessions a week, 90 minutes on weekdays and 30 minutes on Saturdays. After two weeks, the insoles were no longer used by the experimental group. Both groups underwent a battery of tests both before and after this two-week period.

Walking with a cane, the speed of the patients who had used the insoles had tripled (from 0.17 meters/second to 0.55). The walking speed of those who hadn't used the insoles also improved, but not nearly as much (0.17 to 0.28 m/s). And in weight bearing tests conducted while standing, those who had used the insoles bore more weight on their weakened side than they did at the start of the study, while those who had not used the insoles actually bore less.

The researchers hope that other physical therapists will soon begin using the inserts as a standard part of stroke rehabilitation therapy.

An article on the study appears in the 2012 edition of ISRN Rehabilitation and is freely available.

Another study by the same researchers tested the effect of first using the inserts a full year after a stroke. An article on that study will appear in a future issue of Topics in Stroke Rehabilitation.

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