J Korean Phys Ther.  2022 Aug;34(4):161-167. 10.18857/jkpt.2022.34.4.161.

Effect of Uneven Surface Gait Training on Ankle Muscle Activation and Balance in Stroke Patients

  • 1Department of Physical Therapy, College of Medical Science, Catholic University of Daegu, Gyeongsan, Republic of Korea
  • 2Denudeun Hospital, Daegu, Republic of Korea


The purpose of this study was to investigate the effects of regular training on the uneven surface that stroke patients encounter in their daily life on their ankle joint muscle activity and balance ability. They were divided into two groups: the gait training group on uneven surfaces and the gait training group on normal surfaces.
In this study, 30 patients diagnosed with stroke and undergoing rehabilitation were selected. 15 people in the uneven surface gait training group and 15 people in the flat gait training group were selected. The muscle activation of the ankle muscles was measured when walking again on a even surface after walking on an uneven surface and on a flat ground. After each gait training, the limit of stability and Romberg test were performed to evaluate the balance ability.
As a result of the experimental results before and after walking by group, the tibialis anterior muscle activity of the paralyzed side was significantly decreased in the uneven surface walking group. As a result of measuring balance ability after training, the limit of stability in all directions was significantly increased in the uneven surface gait training group, and the area and length moved significantly decreased in the uneven surface gait training group in the Romberg test as well (p < 0.05).
After walking on uneven surface, it was confirmed that the muscle activity of the ankle joint decreased in normal flat walking, and thus the efficiency of muscle activity was increased. In addition, it was possible to confirm the improvement of the balance ability of the gait training on the uneven surface, and in conclusion, it could be confirmed that it had an effect on the improvement of the walking ability.


Stroke; Uneven surface; Gait training; Muscle activation; Balance
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