Bilateral Reinforced Arm Swing Versus Single Arm Restraining on Affected Single Limb Support Time in Stroke Patients

Abstract Background: Stroke is one of the major leading causes of morbidity and mortality worldwide. Hemiparesis is one among the major impairments after stroke. It significantly affects gait performance. Patients use less affected side over the affected side. This differentiated the transverse rotation of trunk and pelvis. Some researchers found that arm sling has positive effects in enhancing gait patterns especially during gait training sessions in hemiparetic patients who have excessive motion of COG. Some studies suggested that pow-erful swing of upper extremities instead of natural movement is more helpful for improving weight shifting of the trunk, and gait kinematics. However, the upper limb swing function during walking has not yet been clarified, and still subject of debate. Aim of Study: To compare between effect of bilateral reinforced arm swing versus single arm restraining on the affected single limb support time in chronic hemiparetic stroke patients to take it into our consideration during gait rehabili-tation after stroke. Patients and Methods: Thirty male patients with chronic stroke with an average age of 54.96±4.5 years participated in this study. All patients performed overground 10-MWT without any assistive devices over a 15-m walkway at self-selected speed in 3 different conditions: Normal arm swing, affected arm restraining using arm sling and bilateral reinforced arm swing randomly for 3 trails each to calculate average walking speed. The same speed calculated was set on the treadmill of Biodex Gait Trainer 2TM system in meter per second (m/sec.) subjects performed a 3-minute walk under each of the previous conditions randomly with time interval 20 minutes between tests for recording of average time on affected side during gait cycle. Results: The mean difference in time on the affected side between normal and sling conditions was –0.37%. There was no significant difference in time on the affected side between normal and sling arm condition (p=1). The mean difference in time on the affected side between normal and powerful conditions was –3.2%. There was a significant increase in time on the affected side in powerful compared with normal arm swing condition (p=0.04). The mean difference in time of the affected side between sling and powerful conditions was –2.83%. There was a significant increase in time on the affected side in powerful compared with sling arm condition (p=0.1). Conclusion: The results suggest that powerful arm swing significantly increased the percent of weight bearing on affected side in chronic hemiparetic stroke patients. Hence, it is recommended to motivate the patient to swing his arm powerfully as much as he can during gait training sessions.