INTRODUCTION
Most hemiplegic patients who suffer from stroke experience restrictions on mobility at home and in the community, and they especially have difficulty with independent walking1). Turnbull et al.2) suggested that the recovery of gait ability is an important goal of physical therapy for a stroke patient, because gait is an important element of functional independence. With regard to this, Mumman3) suggest that the biggest loss after stroke is gait ability, and hemiplegic patients show disorders in the selective ability of regulated and coordinated movements, which results in a slow gait velocity and compensatory movements by the lower extremity of the unaffected side. Perry4) also suggested that hemiplegic patients show a short stride length and slow gait velocity for result of damage to the joint and to the regulatory function of the muscles that are necessary for normal gait. Furthermore, gait is closely connected with the environment, since gait adapts and is modified to overcome obstacles and the varied geography that are faced during walking5). Due to central nervous system damage, stroke patients show muscle weakness, abnormal muscle tone, and disorders of balance and posture control, which result in difficulty in the control of movement6). For these reasons, problems occur with the quality and adaptation of the gait pattern, resulting from imbalance in the low extremity stance phase of the affected side and of the low extremity stance phase of the unaffected side, a decline in cadence and gait velocity, asymmetrical weight distribution, and a difference between step length and stride length7, 8). In particular, gait disorder after stroke reduces the functional independence level and results in a negative prognosis, which is a reason why regaining gait ability is a critical element directly connected with patients’ independence and is one of the goals of rehabilitation9). Neurotherapy methods, which include Bobath therapy and proprioceptive neuromuscular facilitation, mainly focus on the control of abnormal muscle tone and of the asymmetrical movement which leads to gait disorder10). These methods require many therapists and time, because they mainly consist of muscle strengthening movements in a static position through manual handling by a therapist. However, studies on the effects of neurophysiotherapy performed by therapist handling are inconclusive. Therefore, we hypothesized that gait function would improve with pelvic control following a hip extensor strengthening exercise (HESE) program for the paretic lower extremity. We examined whether the HESE program promotes functional improvement of the paretic lower extremity of stroke patients.