Gabriela L Gama1, Melissa L Celestino1, José A Barela2, Larry Forrester3, Jill Whitall4, Ana M Barela5. 1. Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, São Paulo, SP, Brazil. 2. Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, São Paulo, SP, Brazil; Department of Physical Education, São Paulo State University, Rio Claro, SP, Brazil. 3. Maryland Exercise & Robotics Center of Excellence, Veterans Administration Maryland Health Care System, Baltimore, MD. 4. Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD; Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom. 5. Institute of Physical Activity and Sport Sciences, Cruzeiro do Sul University, São Paulo, SP, Brazil. Electronic address: ana.barela@cruzeirodosul.edu.br.
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.
RCT Entities:
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.