Effects of Gait Training With Body Weight Support on a Treadmill Versus Overground in Individuals With Stroke

• Published in: Archives of physical medicine and rehabilitation Vol. 98; no. 4; pp. 738 - 745
• Main Authors: Gama, Gabriela L., MSc, Celestino, Melissa L., MSc, Barela, José A., PhD, Forrester, Larry, PhD, Whitall, Jill, PhD, Barela, Ana M., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2017
• Subjects: Assistive technology; Clinical protocols; Exercise therapy; Exercise Therapy - methods; Female; Gait Disorders, Neurologic - physiopathology; Gait Disorders, Neurologic - rehabilitation; Humans; Lower Extremity - physiopathology; Male; Middle Aged; Physical Endurance - physiology; Physical Medicine and Rehabilitation; Recovery of Function; Rehabilitation; Stroke Rehabilitation - methods; Treatment Outcome; Walk Test; 10MWT; treadmill training group; Assistive technology; 10-meter walk test; FM; body weight support; 6MWT; TMG; 6-minute walk test; Exercise therapy; Fugl-Meyer assessment; Clinical protocols; Rehabilitation; BWS
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2016.11.022

Abstract Objective To investigate the effects of gait training with body weight support (BWS) on a treadmill versus overground in individuals with chronic stroke. Design Randomized controlled trial. Setting University research laboratory. Participants Individuals (N=28) with chronic stroke (>6mo from the stroke event). Interventions Participants were randomly assigned to receive gait training with BWS on a treadmill (n=14) or overground (n=14) 3 times a week for 6 weeks. Main Outcome Measures Gait speed measured using the 10-meter walk test, endurance measured using the 6-minute walk test, functional independence measured using the motor domain of the FIM, lower limb recovery measured using the lower extremity domain of the Fugl-Meyer assessment, step length, step length symmetry ratio, and single-limb support duration. Measurements were obtained at baseline, immediately after the training session, and 6 weeks after the training session. Results At 1 week after the last training session, both groups improved in all outcome measures except paretic step length and step length symmetry ratio, which were improved only in the overground group ( P =.01 and P =.01, respectively). At 6 weeks after the last training session, all improvements remained and the treadmill group also improved paretic step length ( P <.001) but not step length symmetry ratio ( P >.05). Conclusions Individuals with chronic stroke equally improve gait speed and other gait parameters after 18 sessions of BWS gait training on either a treadmill or overground. Only the overground group improved step length symmetry ratio, suggesting a role of integrating overground walking into BWS interventions poststroke.