A Narrative Review of Alternate Gait Training Using Knee-ankle-foot Orthosis in Stroke Patients with Severe Hemiparesis.

Impairments resulting from stroke lead to persistent difficulties with walking. Subsequently, an improved walking ability is one of the highest priorities for people living with stroke. The degree to which gait can be restored after a stroke is related to both the initial impairment in walking ability and the severity of paresis of the lower extremities. However, there are some patients with severe motor paralysis and a markedly disrupted corticospinal tract who regain their gait function. Recently, several case reports have described the recovery of gait function in stroke patients with severe hemiplegia by providing alternate gait training. Multiple studies have demonstrated that gait training can induce "locomotor-like" coordinated muscle activity of paralyzed lower limbs in people with spinal cord injury. In the present review, we discuss the neural mechanisms of gait, and then we review case reports on the restoration of gait function in stroke patients with severe hemiplegia.