Relationship between walking ability of patients with stroke and effect of body weight-supported treadmill training

Abstract

Reports on the amount of unloading maximizing walking ability in patients with stroke are limited. The effect of body weight-supported treadmill training (BWSTT) in patients with stroke has not been clarified. We aimed to investigate the effects of unloading rate during BWSTT on the gait of patients with stroke and the relationship between BWSTT and walking ability on flat ground. [Participants and Methods] We performed BWSTT in 17 patients at three unloading rates: 0%, 20%, and 40%. Then, we examined the walking speed and rate, number of steps, single-leg support time ratio, and root mean square before and after unloading. Furthermore, we examined the relationship between walking ability on flat ground and immediate effects of BWSTT at each unloading rate. [Results] We observed no significant improvement under all conditions. However, walking ability improved at unloading rates of 20% and 40%, with poor temporal symmetry while walking on flat ground. [Conclusion] Our results revealed that BWSTT has diverse effects depending on the unloading rate and the ability to walk on flat ground. In particular, it tends to be highly effective for those who have poor sway and symmetry, which may serve as an index for prescribing BWSTT.

Predicative factors of the effect of Body Weight Support Treadmill Training in stroke hemiparesis patients

“…As previous research indicated that BWSTT can improve left/right symmetry 10 ) , we also calculated the single leg stance time ratio as the index of symmetry, with improvement in this index being the primary outcome of a positive effect of BWSTT on post-stroke gait. In our previous study, the single leg support time ratio on level ground walking correlated with the rate of improvement in the BWSTT single leg support time ratio 6 ) . Therefore, we hypothesized that the ability to walk on level ground may be a predictor of the improvement in the single leg support time ratio by BWSTT.…”

“…The Biodex Unweighing System (NY, USA) was used for BWSTT, with a T650MS treadmill (SportsArt, Tainan City, Taiwan). The BWSTT protocol was based on our previous study 6 ) and included the following parameters: 20% body weight unloading; treadmill speed to the maximum steady state walking speed for each individual; training up to a self-reported fatigue level on the 20-point Borg scale.…”

“…However, BWSTT was effective for those who were able to walk independently on level ground; as such, we can speculate that the effectiveness of BWSTT was influenced by baseline walking ability. Our previous study of BWSTT in 17 stroke patients 6 ) found that the bilateral symmetry during level ground walking before training was associated with the measured effectiveness of BWSTT. The purpose of this study was to evaluate the value of various gait indices in predicting the efficacy of BWSTT.…”