The Effect of Gait Training on a Sandy Beach in Patients with Chronic Stroke: A Randomized Controlled Pilot Study.

Background: A sandy beach provides an unstable support surface and may influence walking ability in patients with stroke. Primary Study Objective: To investigate the effect of gait training on a sandy beach in patients with chronic stroke. Methods/Design: This was a randomized controlled trial. Setting: Patients were recruited from a community center. Participants: A total of 28 patients with chronic stroke participated in the study. Intervention: Patients were randomly assigned to receive gait training either on a sandy beach (sand group) or firm ground (control group). All patients received gait training for 30 minutes per session, 2 sessions every day for 5 days. Context: Primary Outcome Measures • Primary outcomes were 10-minute walk test (10MWT) and Berg Balance Scale (BBS) scores. Secondary outcomes were Functional Ambulatory Category (FAC), Timed Up and Go (TUG) and spatiotemporal parameters of gait evaluated with a wearable inertial sensor. Psychological parameters, including the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI), were also measured. Outcome measurements were evaluated at baseline and after the intervention. Results: The 10MWT and BBS scores were significantly improved in the sand group (P < .05). Compared with the changes from pre- to post-treatment between the groups, 10MWT showed a large effect size and BBS score showed a medium effect size. Regarding spatiotemporal parameters, cadence and gait velocity were significantly higher after training than before training in the sand group (P < .05). Compared with the changes from pre- to post-treatment between groups, cadence and gait velocity showed large effect sizes and affected-side stride length showed a medium effect size. There was no difference in the changes from pre- to post-treatment in BDI and STAI between the 2 groups (P > .05). No adverse events occurred during the study. Conclusion: Gait training on a sandy beach may be beneficial for improving walking ability and balance in patients with stroke.