Effects of body weight-supported treadmill training combined with ball-kicking on balance and gait of subacute stroke patients

Abstract

Objective: This study focused on subacute stroke patients who were asked to kick a ball while walking on a treadmill. The aim of the study was to determine the effect of a body weight-supported treadmill training (BWSTT) combined with ball-kicking on muscle strength, balance, and gait. Design: Single blind, randomized controlled trial. Methods: Twenty stroke patients who volunteered to participate in this study were randomly assigned to either the BWSTT combined with ball-kicking (BWSTT-BK; 10 participants) group or the BWSTT group (10 participants). Participants in the BWSTT-BK group performed treadmill walking combined with simultaneous ball-kicking for 30 minutes daily for 5 weeks. Participants from the BWSTT group performed only treadmill walking. The muscular strength, balance, and gait ability were measured before and after the 5-week training. To assess for muscular strength, a digital muscle tester was used to measure hip flexor, knee extensor, and dorsiflexor strength. To assess for balance, the Berg Balance Scale (BBS) and Timed Up and Go Test (TUG) was used. To assess for gait, the 10 meter walk test (10MWT) and Functional Gait Assessment (FGA) was used. Results: The BWSTT-BK group showed significantly improved muscular strength, balance, and gait according to BBS, TUG, 10MWT, FGA, and digital muscle testing scores compared to the BWSTT group (p<0.05). In addition, within-group comparison showed significant improvement in all variables (p<0.05). Conclusions: These findings suggest that BWSTT-BK results in more favourable outcomes for stroke patients. Therefore, BWSTT-BK may be useful for the recovery of gait ability of stroke patients.

Predictive validity of the gait scale in the Performance Oriented Mobility Assessment for stroke survivors: a retrospective cohort study

“…As a result, subjects with POMA gait scale scores of ＞8.5 were excellent at functional ability (the OLST of affected side, SST, FM-LE, and TIS) compared with subjects with POMA gait scale scores ≤8.5. In general, stroke patients have impaired postural stability [32] and thus rely more heavily on the lower extremity of the non-affected side to maintain balance, and the asymmetrical weight bearing becomes severe [33,34]. In addition, as stroke patients rely more heavily on vision than proprioceptor when performing the OLST [35], postural sway appears more significant and it also has a negative impact on postural control.…”

Effects of ball kicking dual task training on gait performance and balance in individuals with chronic hemiparetic stroke

“…For persons with stroke who have movement and cognitive impairments, it is necessary for them to walk and exercise or perform a cognitive task simultaneously for the prevention of falls during the performance of daily life activities [7]. Choi et al [16] reported improved dynamic balance abilities in dual-task training treadmill training group that followed audible instructions to transfer rings compared to the TGT group.…”

“…Persons who had been diagnosed with stroke at least 6 months ago, thus indicating a chronic stroke, persons who were able to follow instructions and with an Mini-Mental State Examination score of greater than 24 [7], and those who were able to ambulate at least 10 m independently with or without an assistive device were selected to participate in the study [15]. Persons with a heart or orthopedic disorder and those with visual or auditory problems were excluded from this study [15].…”

“…Current studies with stroke patients have shown improvements in gait velocity, stride length, cadence and other spatio-temporal parameters [12]. A study by Cho et al [7] has reported that body weight-supported treadmill training with ball kicking improved the lower extremity strength of the affected side as well as gait velocity and balance abilities in persons with stroke. Although dual-task training is mainly focused on motor tasks, recent studies are showing that exercise training combined with cognitive tasks has a positive effect on gait performance and balance abilities [2,4,13].…”

“…In addition, persons with stroke show a significant decline in gait velocity [7], the normal walking speed is from 20 to 70 for about 1.3 m/s (male, 1.33 m/s; female 1.27 m/s), the average gait speed for persons with stroke is 0.23-0.73 m/s [8]. Because persons with stroke experience difficulty performing their individual roles within the community [9], most persons with stroke consider that the recovery of their Original Article gait is the rehabilitation goal [2,5,10].…”