Publication:

Weight-bearing asymmetry patterns in patients with stroke: a systematic review

Stroke frequently results in weight-bearing asymmetry (WBA), a common motor impairment that negatively affects postural stability, gait, and increases fall risk. Identifying asymmetry patterns and reliable assessment methods is essential for individualized rehabilitation. This systematic review synthesized evidence on weight-bearing asymmetry patterns in stroke survivors and the tools used to assess and quantify them. The review followed PRISMA guidelines. A literature search of PubMed and Google Scholar identified randomized controlled trials published between 2015 and 2025 using keywords related to stroke, hemiplegia, weight bearing, postural control, postural sway, asymmetry patterns, and measurement methods. Eligible studies included individuals with stroke, objective evaluation of WBA, and reporting of asymmetry patterns and measurement tools. Data extraction focused on asymmetry types, assessment methods, and intervention approaches. 7 randomized controlled trials involving approximately 266 participants were included. Common WBA patterns included greater loading on the non-paretic limb, lateral weight shift, and reduced paretic limb loading during static and dynamic tasks. Measurement tools included force platforms, GAITRite systems, weight-bearing scales, and clinical balance measures. Interventions including insoles, weighted gait training, modified sit-to-stand training emphasizing symmetry, ankle–foot orthoses, shoe lifts on the non-paretic limb, tilt-based postural training, and weight-shift-triggered electrical stimulation improved symmetry indices and functional outcomes. Force platforms and symmetry indices were the most reliable methods for capturing static and dynamic asymmetries. Accurate assessment combined with targeted interventions can enhance postural control, gait symmetry, and functional recovery after stroke survivors during rehabilitation programs and clinical practice.