Comparison of Underwater and Overground Treadmill Walking to Improve Gait Pattern and Muscle Strength after Stroke

Abstract

Abstract.[Purpose] The objective of this study was to compare the effect of underwater and overground treadmill walking, which affect gait pattern and muscle strength in people with hemiparesis following a stroke. [Subjects] Twenty chronic stroke patients were included in this study.[Methods] The subjects were randomly allocated to one of two groups, the underwater treadmill walking (UTW) and overground treadmill walking (OTW) groups. The amount of weight the subjects exerted on the foot on the affected side, as well as the joint angle values and muscle strengths on the affected side, were measured. Intervention was performed 4 times per week, and each session lasted 30 minutes. [Results] It was shown that the weight exerted on both the entire foot and hindfoot increased more in the UTW group than in the OTW group. However, the weight put on the forefoot was not found to increase for either group. In terms of the joint angle values, the angle between the hip and the knee showed a greater increase in the UTW group than in the OTW group. In contrast, the ankle joint angle did not show significant change in either of the groups. Muscle strength showed a similar increase in both groups. [Conclusion] These results suggest that after a stroke underwater treadmill walking has a more positive effect on gait pattern than overground treadmill walking.

The effects of an additional weight aquatic exercise program on balance and lower extremity strength in persons with stroke: randomized controlled study

“…This change is due to the advantage of the water environment, which reduces the stress on the joints through buoyancy, which counteracts the gravity felt by the human body on the ground, enabling movement with less force compared with the ground motion [27,28]. It is reported that such underwater gait training im-proves balance ability by increasing the stance phase and weight transfer ability of the affected side [29,30].…”

“…In this study, we performed an aquatic exercise program including underwater gait training with these advantages [38]. Park et al [30] suggested that such underwater gait training is based on the improvement of stability of the lower extremity. Therefore, Jung et al [13] mentioned that applying additional weight was used to improve stability by minimizing the floatation of the lower limb.…”

A Comparison of Underwater Gait Training with Additional Weight Application and Over-ground Gait Training to Improve Balance and Lower Extremity Strength in Persons with Stroke

“…Jung et al 9 conducted movement analysis after conducting aquatic treadmill training with affected side ankle weight load application as a cross-sectional study and as a result, during aquatic treadmill training with weight load application, compared to the control group, the weight load group showed increase of stability in the affected side lower limb. In the study by Park et al 29 there was a ter applying an additional weight load on the affected side ankle, and in the study by Regnaux et al 30 it was reported that an average of 6 cm/s gait speed improvement was represented after conducting contralateral side lower limb weight load treadmill gait training. In the movement analysis of aquatic gait training in the study by Barela et al, 31 it was reported at there was increase of muscle activity in the stance phase in the tensor fasciae latae muscle, vastus lateralis muscle, and biceps femoris muscle.…”

Effects of Eye Movement with PNF Neck Movement on Trunk Stability and Standing Position Balance Ability of Chronic Stroke Patients

“…Stroke causes the psychological disorder with the and depending on the lesion site, the representative functional disorders of exercise, sense, gait, and balance, among which, disorders of gait and balance occur due to impairment of the motor and sensory nerves [5]. In addition, stroke patients tend to have difficulty performing tasks involving high positions, such as sitting, standing, walking, and stair climbing [6].…”