Light Touch Cue Through a Cane Improves Pelvic Stability During Walking in Stroke

Abstract

Objective To examine the effect of a light touch cue provided through a cane on mediolateral (ML) pelvic stability during walking in subjects poststroke. Design Crossover trial examining ML pelvic stability during walking using a cane with the force contact and touch contact methods. Setting Physical therapy clinic, tertiary care center. Participants Subacute patients (N=40) with stroke with a mean age of 59.6 years and mean stroke duration of 46.8 days. The average gait speed with a cane was .13m/s (.05–.29m/s). Intervention Using a cane with the force contact and touch contact methods during walking. Main Outcome Measures ML pelvic stability as measured by averaged peak-to-peak pelvic acceleration, muscle activation of bilateral tensor fascia latae (TFL), semitendinosus (ST), and vastus medialis (VM) using an electromyography system, and vertical cane force. Results The average amount of cane force during touch contact and force contact cane use conditions was 2.3N and 49.3N, respectively. A light touch cue through a cane was required only when the paretic leg accepted the body weight, and this cue can provide ML pelvic stability (.16g of average pelvic acceleration) during walking to the same degree as the force contact method of cane use. However, significant increases in single-limb support duration with higher activations of TFL, VM, and ST muscles on the paretic leg were found during the paretic stance phase when using a cane in the touch contact fashion (P<.05). Conclusions A light touch cue can be provided during walking through the use of a cane. This augmented somatosensory information provides lateral stability during walking for subjects with stroke by facilitating the activations of weight-bearing muscles on the paretic leg during the stance phase.