Walking ability is an important element for independent
living in stroke patients1). Various studies have been conducted
to improve the walking ability in stroke, as recovery
of walking ability is a rehabilitation goal for most stroke
patients2).
Treadmill training was suggested to be an effective
method for improving the walking ability in stroke in a systematic
review3). Olney et al. demonstrated that treadmill
training is a type of forced use and that it also could improve
both quality and quantity aspects of walking4).
Balance ability is an important factor for independent
walking in stroke patients5, 6). For stable and functional
walking, increasing the balance ability is a prior to other
capacity7). Numerous interventions have been devised to
improve balance, such as unstable surface training (UST)8),
balance training9), and virtual reality programs10). UST in
particular has been proven to improve the strength, proprioception,
and balance ability of the lower extremity8). Some
authors have reported that UST increased the weight bearing
ratio by more in the affected lower limb in stroke patients7,
8). UST has also been shown to positively influence
muscle activation and improvement of balance ability8).
However, most of the studies that have been conducted
to date have only evaluated the effects of UST on balance
ability. Little is known about the effects of UST on lower
extremity function, especially walking performance for independent
living in stroke patients. Therefore, the purpose
of this study was to investigate whether UST influences
walking ability during treadmill training in stroke patients.
We hypothesize that a UST and with treadmill training
group will show greater improvements in the 10-meter walk
test, Timed Up and Go test, and 6-minute walk test compared
with a control group performing treadmill training
alone.