Effect of vestibular rehabilitation therapy on spatio-temporal gait parameters in elderly patients with post-stroke hemineglect

Introduction: Hemineglect is a lack of awareness for the contralesional space. It is a complex neurologic condition to rehabilitate. The study was designed to investigate the effects of vestibular rehabilitation therapy (VRT) on spatio-temporal gait parameters in hemineglect. Material and methods: Thirty-two hemineglect patients were randomly assigned to the experimental and the control group. The experimental group received 60 minutes of training (4 days/week) for the first four weeks (40 minutes traditional physiotherapy and 20 minutes VRT) and then completed the following four weeks with 60 minutes of only traditional physiotherapy. For eight weeks, the control group completed 60 minutes of the traditional program four days a week. The Microsoft Kinect V2 was used to measure spatio-temporal gait parameters. Patients were assessed at baseline, four and eight weeks post-intervention. Results: After four and eight weeks of intervention, the experimental group demonstrated a significant improvement in walking speed (P = 0.0002, d = 12.38 and P = 0.001, d = 13.69, respectively), cadence (P = 0.0003, d = 3.88, and P = 0.0003, d = 5.19, respectively), paretic step length (P = 0.0001, d = 2.53, and P = 0.001, d = 3.84, respectively), and non-paretic step length (P = 0.0119, d = 2.06, and P = 0.0044, d = 2.31, respectively). There were no significant differences in the control group in any of the spatio-temporal gait parameters. Conclusions: VRT improves the spatio-temporal gait parameters in hemineglect, allowing patients to walk more securely and navigate more easily during walking. VRT might improve the patients’ postural control, weight distribution, and orientation during walking. This improvement was maintained following training, and additional improvements in spatio-temporal gait parameters were observed compared to baseline.