Impact of timing and regularity of rehabilitation on gait disturbances in patients after a stroke

Introduction: The increasing stroke incidence due to demographic changes in society leads to a growing numbers of patients requiring post-stroke rehabilitation. Effective post-stroke rehabilitation should lead to improvement in motor functions. Pedography allows for an objective assessment of improvement in gait disturbances and thus the effectiveness of the treatment. The aim of the study was to estimate the impact of timing and regularity of treatment on gait disturbances assessed with pedography.Material and Methods: One hundred and twenty consecutive patients (44 women, 76 men, average age 76) were included. All were hemiparetic after stroke (95 ischemic; 25 hemorrhagic). During 4 weeks of the treatment period intensive rehabilitation, 5 days a week, was provided. Ninety patients received treatment regularly, while 30 patients had interruptions in the treatment. Gait parameters were measured with the use of a pedography platform. Pedography was performed before and after the treatment. Improvement after treatment was recognized when asymmetry in the gait parameters between the paretic and healthy limb disappeared. The effects of the treatments were compared depending on the regularity of the treatment and the time from the stroke event i.e. less then 6 months, between 6 and 12 months and more then one year.Results: Significant asymmetry in gait parameters was found in the first measurements before the treatment. After 4 weeks of rehabilitation sessions the asymmetry in recorded parameters disappeared only in systematically treated patients. The best results were found in the subgroup of patients in which the rehabilitation program had been introduced within 6 months after the stroke event. Conclusions: The regularity of the treatment is essential to obtain an improvement in gait disturbances after stroke. The rehabilitation program should be introduced as soon as possible after a stroke to obtain the best effects of the treatment. Pedography is a useful tool for assessment of the effectiveness of the rehabilitation program in stroke patients.