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On Sep 2018




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Prof. Somashekhar Nimbalkar
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Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Professor and Head
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Saraswati Dental College
Lucknow
On Sep 2018




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MD, DM (Clinical Pharmacology)
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Calcutta National Medical College & Hospital , Kolkata




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Best regards,
C.S. Ramesh Babu,
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Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : April | Volume : 16 | Issue : 4 | Page : YC06 - YC10 Full Version

Effect of Visual Cue Training on Gait and Walking Velocity in Chronic Stroke Patients- A Quasi-experimental Study


Published: April 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/50349.16227
Shreya Upadhyay, Neha Verma

1. Assistant Professor, Department of Physiotherapy, Shrimad Rajchandra College of Physiotherapy, Surat, Gujarat, India. 2. Assistant Professor, Department of Physiotherapy, SPB Physiotherapy College, Surat, Gujarat, India.

Correspondence Address :
Neha Verma,
Assistant Professor, Department of Physiotherapy, SPB Physiotherapy College, Surat, Gujarat, India.
E-mail: nidhiverma4@gmail.com

Abstract

Introduction: Stroke is the major cause of disability and death in the world. More than 80% of stroke survivors face walking impairment due to muscle weakness, incoordination and spasticity. For physical rehabilitation of patients with neurological conditions combination of approaches are used. Visual cuing techniques are useful approaches for rehabilitation but the effect of visual cue training for gait and walking velocity is less explored for a patient with chronic stroke.

Aim: To determine the effect of visual cue training on gait and walking velocity in subjects with chronic stroke.

Materials and Methods: This was a quasi-experimental study in which 38 patients of chronic stroke were selected from various physiotherapy Outpatient Departments (OPD), of Surat, Gujarat from January 2019 to August 2020. Samples were randomly allocated into two groups, group A and group B; conventional and experimental group respectively. Group A was given conventional training and group B was given visual cue training along with conventional training for three days a week, 20 minutes/session. Both groups received conventional training five days a week, for four weeks. Dynamic Gait Index (DGI) and walking velocity were taken as an outcome measure and checked before intervention and after the end of four weeks of intervention. Statistical analysis was done using Statistical Package of the Social Sciences (SPSS) version 16.0. Paired t-test was carried out for within group comparison.

Results: The results of the study indicates that there was significant difference in DGI and walking speed preintervention and postintervention in both the groups (p<0.001). The mean difference of DGI in group A and B was 1.94±0.002 and 3. 26±0.41, respectively (p<0.001). The result of the study suggests that there is greater improvement in visual cue training group.

Conclusion: The present study results conclude that visual cue training along with conventional training shows greater improvements in gait and walking velocity than the conventional training alone.

Keywords

Attention allocation, Dynamic gait index, Vision, Visual feedback

Stroke is an acute, neurological event that is caused by an alteration in blood flow to the brain. The traditional definition of stroke, given by World Health Organisation (WHO) in the 1970s is ‘Neurological deficit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours (1). Stroke is one of the leading causes of death and disability in India. The prevalence rate of stroke ranges, 84-262/100,000 in rural and 334-424/100,000 in urban areas and the incidence rate is 119-145/100,000 based on the recent studies. There is also a wide variation in case fatality rates with the highest being 42% in Kolkata (2).

Disability and impairment have a considerable effect on patient’s life, health and cost of social service. Despite of patients receiving standard rehabilitation there will be some degree of residual impairment and approximately 50% of patients are partially dependent in Activities of Daily Living (ADL) (3). For rehabilitation of stroke patients, gait recovery is the major objective from all other problems to make patients less dependent in ADLs (4). Only 30% of stroke patients can walk with the speed greater than 0.8 m/s after rehabilitation which is considered as the normal (5).

Various rehabilitation approaches like Bobath, motor relearning, neurodevelopment techniques are used as therapeutic treatment protocols to improve gait after stroke. This gait rehabilitation includes various methods such as neurodevelopmental approach, strength training, treadmill training, Despite of these multiple approaches gait impairments remain unchanged (6),(7). In stroke a single rehabilitation approach cannot significantly improve patient’s condition. Cuing strategies are more useful rehabilitation approach along with other technique of rehabilitation as in the disorders like stroke (8). Cues can be given by various cuing modalities such as auditory cuing, visual cuing, tactile cuing, and vibratory cuing from which auditory cuing has shown promising results in Parkinson’s and stroke patients. From last decades visual cues are also aimed to improve gait and coordination as auditory cues in people with stroke (9),(10).

The systemic review study of the Kristen Hollands in stroke patients shows that auditory cuing has promising improvement in the coordination of walking but still the effectiveness of other cuing modalities in improving gait and walking velocity in stroke patients are the unexplored concept (11). There is vast amount of literature available on the effect of cuing technique on the gait of patients with neurological conditions specifically the effect of rhythmic auditory and visual cuing in patients with Parkinson’s diseases and the concept is widely accepted and used in clinical practice.

There are very few studies on the effect of visual cue training in stroke patients, so objective of the study is to identify the effect of visual cue training to improve gait and walking velocity in chronic stroke patients (11),(12).

Material and Methods

A quasi-experimental study was conducted for a duration of one and a half year from January 2019 to August 2020 after obtaining ethical approval from Institutional Ethical Committee (No: EC/SPB/020). Total 52 subjects were assessed for eligibility and 38 subjects were included from various physiotherapy OPDs of Surat, Gujarat India.

Sample size calculation: Sample size was calculated by pilot study using G power software (α=0.05 and power 80%, effect size=1.021, 10% drop out; sample size N=38).

Inclusion criteria: Subjects fulfilling the following criteria were included in the study:

• Age: 45-75 years;
• First episode of stroke;
• Duration of 6-18 months after first episode;
• Mental competency on Mini mental state examination ->24 (13);
• Fugl meyer Assessment (lower limb) -<34 (14);
• Tone on modified Ashworth scale -<3 (15).
• Berg Balance Scale -≥35 (16);
• Functional ambulation class: 3 or more than 3

Exclusion criteria: Subjects were excluded if they had any visual impairment, perceptual disorders, vestibular disorders, cognitive impairment, severe aphasia, gait deficit attributable to non stroke pathology and also subjects who were having gait speed more than 0.8 m/s (18).

Study Procedure

A written informed consent was obtained from subjects and they were allocated in two groups a conventional training group and visual cue training group using a lottery method. DGI and gait speed were measured using standardised procedure before starting intervention (19),(20). DGI is an observer type assessment tool which comprised of eight items and the total highest possible score is 24. Patient is made to perform the eight different tasks and then the score is recorded. To check gait speed the 10-meter walk test was performed on a 14 meter long pathway to account for acceleration and deceleration effect. The procedure was repeated twice and the average value of time for two test results was calculated and recorded in minutes (21). A step length of subjects allocated to visual cue training group was measured by dipping foot of patients in boric powder and making them walk along a 10-meter walkway and at least six foot prints were taken to measure step length (22). Average of hemiparetic limb and non hemiparetic limb step length was calculated and the summated distance of step length was used as the baseline step length for making visual cues. (Table/Fig 1) shows the flow diagram of the study procedure.

Intervention protocol: Following exercises were given to the patients as the part of conventional training (23):

• Range of motion exercises of affected extremity;
• Passive stretching of tight muscles;
• Grip strengthening exercise;
• Strength training using free weights and elastic bandage for upper and lower limb major muscle groups.
• Conventional gait training:
• Marching at place;
• Walking forward, backward and sideways;
• Mat exercises- prone on hands, quadripod, kneeling and half kneeling

Number of repetitions and intensity of each exercise were increased based on patient’s performance. The conventional training was given for four weeks, five sessions per week. One session of training last for around 40 minutes.

Visual cue training: For visual cue training visual cues were made on the floor using a white chalk. 2.5 cm wide and 90 cm long parallel lines were drawn on a 10-meter walkway. The inter line distance was kept 110% of the baseline step length (24). The interline distance was gradually increased to 120%, 130%, 140% of baseline step length in 2nd 3rd and 4th week, respectively. Visual cue training was given for four weeks three sessions per week for 20 minutes per session. The protocol for conventional training was same as the conventional training group. After completion of four weeks the DGI and walking speed were measured.

Example: If average paretic step length is 23 cm and non paretic step length is 17 cm. The average summated step length of the patient will be 20 cm. For patients with baseline step length of 20 cm the distance between two parallel lines for visual cue training in consecutive week will be as follows (Table/Fig 2),(Table/Fig 3),(Table/Fig 4).

Week 1: Distance between two lines is 110% of summated step length i.e., 22 cm

Week 2: Distance between two lines is 120% of summated step length i.e., 24 cm

Week 3: Distance between two lines is 130% of summated step length i.e., 26 cm

Week 4: Distance between two lines is 140% of summated step length i.e., 28 cm

Statistical Analysis

Statistical analysis was done using SPSS version 16.0. To analyse difference between pretraining and posttraining paired t-test was used and for the between group comparison independent t-test was used. The level of significance for all statistical data was set at α=0.005. Independent t-test was used to analyse difference between two groups.

Results

The result of the study shows significant improvement in visual cue training group. The group A receiving conventional training consisted of 14 males and five females with the mean age of 55.21±8.175 years and group B receiving visual cue training consisted of nine males and 10 females with mean age of 60.52±9.50 years. The p-value evaluation of the outcomes at the baseline was 0.552 and 0.515 for DGI and 10-metre walk test indicates that both the groups were homogenous at the baseline (Table/Fig 5).

The result of paired t-test for intragroup comparison shows significant improvement in both the groups (Table/Fig 6).

The result of intergroup comparison shows significant improvement in DGI and 10 MWT in visual cue training group (Table/Fig 7),(Table/Fig 8).

Discussion

The result of the study suggested that visual cue training along with conventional training showed promising result on gait and walking velocity in subjects with chronic stroke. There is significant difference (p<0.001) in DGI and 10 MWT between group A and group B. The mean DGI change in visual cue training group was 3.26 which is higher than which is higher than the minimal detectable change of DGI (25). The possible mechanism of improvement in conventional training group could be the promoted learning and reorganising the work by non damaged brain areas due to involvement of structured repetitive exercises in every day (26).

Studies on the effect visual cue training on different neurological conditions were published previously supports the findings of the present study (12),(27). Robert De icco et al., conducted a study in 2016 with 46 Parkinson’s disease patient which suggests that gait training with cues is more effective than normal gait training (27). Another study of Chouhan S et al., was conducted in 2012 on 45 acute stroke patients also suggests that cuing training is effective compared to conventional training alone (12).

The possible neuro physiological mechanism behind the improvement in visual training group could be the allocation of attention during walking as it plays major role in gait control (28). Stepping on the line of certain length distance improves attention along with induction in the dynamic visual flow for maintenance of locomotor pattern (29),(30). As attention is improved it changes to corticalised task (31),(32). The visual information converted into action is called visual motor process. The sensory information received during visually guided movement reaches to dentate nucleus of cerebellum for generation of movement (33). This attention to visual information activates the cerebellum and basal ganglia which has reciprocal connection with brain stem and cerebral cortex for control of automatic motor process (34).

Another mechanism responsible for the significant positive change in gait and velocity could be the visual feedback as it enhances the motor function (35). Due to linkage between the oculomotor and locomotor pathway there is a change in muscle co-ordination pattern which leads to controlled gait movement (5),(36),(37). Postural sway of paretic leg decreases and the ankle movement increases to improve body control. In addition, visual movements improves accuracy and precision of foot placement (38),(39). Comparison between similar studies have been done in (Table/Fig 9) (11),(12),(27),(40),(41),(42),(43),(44),(45).

Clinical implication: The study serves as a basis for the use of visual cue training as an additional treatment approach to improve locomotor function of chronic stroke patients in clinical setting. Moreover this technique requires a minimum investment because it needs devices with basic technology which are readily available in market at low cost.

Limitation(s)

In addition to favourable results in gait outcome, this study has some limitations. There was a lack of follow-up after one month to determine the long-term effects of training for the participants. Hence, similar studies are suggested for the detection of long-term effect. The sample size used in this study was small, which implies that caution should be exercised when interpreting or generalising the results to entire stroke population. Due to lack of the literature on the effect of the visual cue training in stroke patients, there should be further studies advocated with larger sample size to collect more accurate results.

Conclusion

In the present study, one month of training imparted to both the groups was effective in improving gait and walking velocity in chronic stroke patients after four weeks of intervention, however visual cue training was more effective than the conventional training alone. Furthermore this study provides evidence towards the cost-effective method of using external visual cue which can be used as an additional neurorehabilitative treatment in clinical settings without advance equipments.

A study with variable outcome such as gait of the stroke patient can be assessed with the use of a gait lab or other electromechanical devices to know precise change in the gait kinematics during walking after the intervention. Further study on the transverse line visual cues can be conducted to know the effect of visual cue training on the step length symmetry of paretic patients as an outcome because asymmetric step length leads to increase number of falls. Despite the increasing evidence that visual cue training may become a useful strategy in stroke rehabilitation, future research is required to determine optimal frequency, intensity and duration before its translation into standard clinical practice. Further study including the different stroke population such as sub-acute stroke patients can be administered for the results and clinical implementation.

References

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Sullivan SO, Schmitz TJ, Fulk GD. "Physical Rehabilitation, 6th edition" (2014). Faculty Bookshelf. 85. https://hsrc.himmelfarb.gwu.edu/books/85.
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Belda-Lois JM, Mena-del Horno S, Bermejo-Bosch I, Moreno JC, Pons JL, Farina D, et al. Rehabilitation of gait after stroke: A review towards a top-down approach. Journal of Neuroengineering and Rehabilitation. 2011;8(1):66. [crossref] [PubMed]
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Balaban B, Tok F. Gait disturbances in patients with stroke. PM&R. 2014;6(7):635-42. [crossref] [PubMed]
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Balasubramanian CK, Bowden MG, Neptune RR, Kautz SA. Relationship between step length asymmetry and walking performance in subjects with chronic hemiparesis. Archives of Physical Medicine and Rehabilitation. 2007;88(1):43-49. [crossref] [PubMed]
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DOI and Others

DOI: 10.7860/JCDR/2022/50349.16227

Date of Submission: May 16, 2021
Date of Peer Review: Oct 09, 2021
Date of Acceptance: Jan 05, 2022
Date of Publishing: Apr 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: May 17, 2021
• Manual Googling: Dec 28, 2021
• iThenticate Software: Jan 01, 2022 (8%)

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