The effects of treadmill training with visual feedback and rhythmic auditory cue on gait and balance in chronic stroke patients: A randomized controlled trial

BACKGROUND: Many stroke patients show reduced walking abilities, characterized by asymmetric walking patterns. For such patients, restoration of walking symmetry is important. OBJECTIVE: This study investigates the effect of treadmill training with visual feedback and rhythmic auditory cue (VF+RAC) for walking symmetry on spatiotemporal gait parameters and balance abilities. METHODS: Thirty-two patients with chronic stroke participated in this study. Participants were randomized to either the VF+RAC (n = 16) or the Control (n = 16) group. The VF+RAC group received treadmill training with VF and RAC, and the Control group underwent treadmill training without any visual and auditory stimulation. VF+RAC and Control groups were trained three times per week for eight weeks. After eight weeks of training, the spatiotemporal gait parameters, Timed up and go test, and Berg balance scale were measured. RESULTS: The VF+RAC group significantly improved balance and spatiotemporal parameters except for non-paretic single limb support compared to the Control group. CONCLUSIONS: This study demonstrated that treadmill training with VF+RAC significantly improved spatiotemporal gait symmetry, including other gait parameters, and enhanced balance abilities in stroke patients. Therefore, treadmill training with VF+RAC could be a beneficial intervention in clinical settings for stroke patients who need improvement in their gait and balance abilities.