Improvements in Gait Function Following Integrative Korean-Western Medicine Treatment in Older Adults with Chronic Stroke: A Retrospective Exploratory Study.

چکیده اصلی

Background and Objectives: Patients with chronic stroke aged 65 years or older and who are more than 6 months post-onset are generally considered to have reached a rehabilitation plateau, beyond which further functional improvement is difficult to achieve. This study aimed to evaluate changes in gait function before and after integrative Korean-Western medicine treatment in older adults with chronic stroke. Materials and Methods: In this single-center, retrospective, single-group pre-post observational study, we analyzed the medical records of 15 patients with chronic stroke aged ≥65 years who received integrative Korean-Western medicine treatment five times per week for 4 weeks. The primary outcome was the step length ratio, reflecting gait symmetry. Secondary outcomes included walking velocity, lateral symmetry, center of pressure (COP)-related parameters, manual muscle test (MMT) scores, and Fugl-Meyer Assessment (FMA) scores. Results: The step length ratio increased significantly from 0.61 [0.50-0.70] before treatment to 0.86 [0.62-0.94] after treatment (p = 0.009, r = 0.675). Walking velocity (p = 0.006, r = 0.715) and mean COP velocity (p = 0.007, d = -0.822) also improved significantly. In contrast, no significant changes were observed in MMT or FMA scores, and no treatment-related adverse events were recorded. Conclusions: In this retrospective, uncontrolled, single-group study, significant improvements in gait symmetry, walking velocity, and postural control were observed following integrative Korean-Western medicine treatment in older adults with chronic stroke. The improvement in gait function without a corresponding change in FMA-based motor function-although both MMT and FMA scores were relatively high at baseline, potentially limiting sensitivity to detect further motor improvement-raises the hypothesis that other mechanisms, potentially including enhanced sensorimotor integration, may have contributed to these changes; however, this mechanistic interpretation remains speculative and was not directly tested. Randomized controlled trials with appropriate control groups are warranted to further verify these findings.

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