Effect of the spacing technique to improve balance and gait in stroke survivor: An experimental study

Background: Spacing effect is the observation that information presented using spaced repetitions is better remembered than information presented via massed repetitions (Challis, 1993). Many studies of spacing effect reported positive effect on motor learning, but there is a limited application of spacing strategies for the people with stroke which could potentially result in a significant improvement in balance and gait training for everyday functioning. The aim of this study was to determine whether spaced learning improves motor learning as regards balance and gait in people with stroke. Objectives: The aim of this study is to study the effect of spacing technique in improving balance and gait in patients with stroke. Study Design: This study is in pretest–posttest experimental study design. Methods: Thirty patients with stroke were selected and randomly assigned to Experimental and Control groups. Experimental group consists of 15 patients with 9 males and 6 females patients who received conventional therapy along with spaced exercise protocol thrice a week for 8 weeks. Control group consists of 15 patients with 12 male and 3 female patients who received conventional therapy. Tinetti Performance-Oriented Mobility Assessment (TPOMA) was used as an outcome measure. Results: Statistical analysis showed that there was significant improvement in the Experimental group, measured with TPOMA on Mann–Whitney U-test where the result shows U = 14 which corresponds to P= 0.000 along with 95% confidence interval (0.000, 0.095). Conclusions: The study concluded that application of the spacing technique program with conventional therapy improves balance and gait more effectively than only with the conventional therapy. Thus, spacing effect or spaced interval practice along with conventional therapy should be considered during the management of stroke population to improve balance and gait.