The Effects of Wearing the Toe Spreader During Adaptation Training on Plantar Pressure and Balance in Stroke Patients

PURPOSE: This study aimed to investigate whether a toe spreader can be used as an assistive device in therapeutic interventions aimed at improving plantar pressure and balance ability in patients with stroke during adaptation training.METHODS: This study employed a quasi-experimental design with a crossover format within the same group, applying two conditions to prevent order effects related to wearing and not wearing a toe spreader on measurement results. Thirty patients with stroke participated in this study. Plantar pressure and static and dynamic balance were measured using Zebris and BioRescue systems. Data were analyzed using a paired t-test with SPSS 26.0 for Windows program, and the statistical significance level (α) was set to .05.RESULTS: As a result of the study, compared with the condition without wearing condition, significant differences were observed in plantar pressure on the paretic side and in the surface area and path length of center of pressure displacement during static and dynamic balance measurements after standing adaptation training when wearing the toe spreader (<i>p</i><.05). Similarly, after weight-shift adaptation training in the standing position, significant differences were observed in plantar pressure on the paretic side and in both the surface area and path length of the center of pressure displacement during static and dynamic balance measurements when wearing the toe spreader compared with the condition without wearing the spreader (<i>p</i><.05).CONCLUSIONS: The use of a toe spreader during adaptation training in patients with stroke may serve as a valuable assistive device for therapeutic interventions to enhance plantar pressure and balance.