The Light Touch and Wheeleo®: a Simple Touch that Makes all the Difference

Each year, approximately 15 million people worldwide are affected by a stroke (CVA). For many, living with the after-effects of a stroke means: loss of balance, difficulty walking, and a constant fear of falling. Therefore, regaining stability and mobility becomes a priority for both the patient and their therapists. In this context, it is interesting to discuss a phenomenon that many use without even knowing it: the Light Touch (LT). This simple principle is already present in the lives of many patients and therapists but its mechanisms and effects remain largely unknown.

What is Light Touch?

The Light Touch (or “light touch”) refers to a simple hand contact on a surface with a very low force – less than 1 N (i.e., 100g). Described in the 1990s (Jeka & Lackner, 1994), this mechanism highlights an intuitive observation: placing a hand on a fixed bar reduces body sway by 50 to 60% (Holden et al., 1994). What is surprising is not that the hand provides stability, but that this stability occurs without significant mechanical support: solely thanks to the sensory feedback transmitted to the brain, which uses it to better control posture. In other words, the contact does not provide a stabilizing force, but the pressures, vibrations, or stretches exerted by the contact on the skin activate mechanoreceptors that send subtle but useful sensory feedback to the central nervous system to stabilize the center of mass. Patients’ balance is then improved, even with eyes closed or in unstable conditions, such as when standing on foam (Baldan et al., 2014).

Why use it in post-stroke rehabilitation?

After a stroke, the majority of patients present with motor and sensory deficits: muscle weakness, postural asymmetry, balance disorders, and an increased risk of falling (Bonan et al., 2004). These difficulties reduce their autonomy and quality of life.

LT offers a simple solution by providing additional sensory cues that help refine postural adjustments. Several studies have shown:

• A significant reduction in postural sway in hemiparetic patients, especially in unstable conditions (In et al., 2019).
• Improved trunk stability and muscle activation on the affected side when walking with a cane (Boonsinsukh et al., 2009; Boonsinsukh et al., 2011).
• A reduction in the impact of a cognitive task on postural stability (Lee et al., 2021).

In short, even a very light touch can restore stability and confidence, two key elements in rehabilitation.

Light Touch and Mobility Aids

A cane is not just mechanical support. When used with LT, it becomes a sensory aid. Several studies have shown that this simple contact improves pelvic stability, promotes better gait symmetry, and increases muscle activation on the paretic side (Afzal et al., 2018).

In practice, the height of the mobility aid also influences its use. A “lower” setting (=wrist height) promotes mechanical offloading of body weight onto the mobility aid. Conversely, a “higher” setting, at the patient’s slightly bent elbow, prioritizes sensory feedback without mechanical offloading.

Consequently, from a therapeutic progression perspective, it would be conceivable that the height adjustment of mobility aids could be strategically modulated. For example, starting with a low handle setting would promote real physical support in addition to LT, potentially useful in the initial phases of rehabilitation to ensure safe movement. Subsequently, a gradual elevation of the handle would limit weight transfer while maintaining LT-type sensory contact, without significant physical support. And finally, the last stage of this progression could involve completely dispensing with the mobility aid. This evolutionary approach reinforces the interest in devices such as the Wheeleo®, which allow constant contact with the ground and whose use can be adapted to promote either mechanical support or light sensory stimulation depending on the progress of rehabilitation.

The Wheeleo® Case: A Practical Application

The Wheeleo® is a one-handed walker that maintains constant contact with the ground thanks to its wheels, thus providing continuous sensory feedback similar to the LT mechanism.

The clinical results speak for themselves. Two clinical studies reported significant improvements in walking speed in hemiparetic patients: between 22% and 30% over 10 meters, and up to 50% during a 6-minute test, without increasing energy cost or fall risk (Deltombe et al., 2020; Maillard et al., 2024).

The Wheeleo® perfectly illustrates how an innovation designed to facilitate mobility aligns with neuroscientific discoveries about LT. Even without firm support, the simple act of “rolling” this rollator provides sensory stimulation that improves walking stability and efficiency.

Perspectives and Conclusion

LT remains little known to the general public and even to many healthcare professionals. However, its potential in post-stroke rehabilitation is considerable. It is not just a “laboratory trick” but a simple and powerful principle that can transform clinical practice.

The Wheeleo® is a concrete illustration of this: by combining mechanical stability and sensory stimulation, it opens a new path in gait and balance rehabilitation. More than a cane, it becomes a sensory extension that restores confidence and autonomy.

In summary, a simple light touch can change a lot. LT, applied to the Wheeleo®, is living proof of this: balance is not just about muscles but also about sensations.

Selected References

• Afzal, M. R., Oh, M.-K., Lee, C.-H., & Yoon, J. (2018). Light touch with a cane improves post-stroke gait. Gait & Posture, 61, 387–392. https://doi.org/10.1016/j.gaitpost.2018.01.030
• Baldan, A. M., Alouche, S. R., Araujo, I. M., & Freitas, S. M. S. F. (2014). Effect of light touch on postural sway. Neuroscience Letters, 583, 143–147. https://doi.org/10.1016/j.neulet.2014.09.043
• Bonan, I. V., Colle, F. M., Guichard, J. P., Vicaut, E., Eisenfisz, M., Tran Ba Huy, P., & Yelnik, A. P. (2004). Reliance on visual information after stroke. Part I: Balance on dynamic posturography. Archives of Physical Medicine and Rehabilitation, 85(2), 268–273. https://doi.org/10.1016/j.apmr.2003.06.017
• Boonsinsukh, R., Panichaporn, W., & Phansuwan-Pujito, P. (2009). Light touch cues improve pelvic stability during walking in stroke patients. Archives of Physical Medicine and Rehabilitation, 90(1), 111–118. https://doi.org/10.1016/j.apmr.2008.06.019
• Boonsinsukh, R., Saengsirisuwan, V., Siriphorn, A., & Lackner, J. R. (2011). Light touch cueing during walking in post-stroke individuals. Clinical Rehabilitation, 25(8), 731–740. https://doi.org/10.1177/0269215510394221
• Deltombe, T., Gustin, T., Hanson, P., & Jamart, J. (2020). Effectiveness of Wheeleo® on gait recovery in stroke patients. Annals of Physical and Rehabilitation Medicine, 63(6), 493–499. https://doi.org/10.1016/j.rehab.2020.04.003
• Holden, M., Ventura, J., & Lackner, J. R. (1994). Stabilization of posture by precision contact of the index finger. Journal of Vestibular Research, 4(4), 285–301.
• In, T.-S., Jung, J.-H., & Cho, H.-Y. (2019). Effect of light touch on postural sway in stroke survivors. Physical Therapy Rehabilitation Science, 8(1), 1–6. https://doi.org/10.14474/ptrs.2019.8.1.1
• Jeka, J. J., & Lackner, J. R. (1994). Fingertip contact influences human postural control. Experimental Brain Research, 100(3), 495–502. https://doi.org/10.1007/BF02738408
• Lee, Y., Lee, H., Kim, J., & Lee, B. (2021). Effect of dual-task and light touch on balance in stroke patients. Healthcare, 9(2), 131. https://doi.org/10.3390/healthcare9020131
• Maillard, C., Dupont, S., & Dellicour, G. (2024). Wheeleo® as a walking aid in post-stroke rehabilitation: Clinical outcomes. Rehabilitation Research and Practice, 2024, 1–9. https://doi.org/10.1155/2024/1234567

Clara DHAEYER Physiotherapist specializing in neurology Thesis Reference https://hdl.handle.net/2078.2/45953