The Effect of Body Weight Support Treadmill Training on Gait Recovery, Proximal Lower Limb Motor Pattern, and Balance in Patients with Subacute Stroke

Abstract

Objective. Gait performance is an indicator of mobility impairment after stroke. This study evaluated changes in balance, lower extremity motor function, and spatiotemporal gait parameters after receiving body weight supported treadmill training (BWSTT) and conventional overground walking training (CT) in patients with subacute stroke using 3D motion analysis. Setting. Inpatient department of rehabilitation medicine at a university-affiliated hospital. Participants. 24 subjects with unilateral hemiplegia in the subacute stage were randomized to the BWSTT (n = 12) and CT (n = 12) groups. Parameters were compared between the two groups. Data from twelve age matched healthy subjects were recorded as reference. Interventions. Patients received gait training with BWSTT or CT for an average of 30 minutes/day, 5 days/week, for 3 weeks. Main Outcome Measures. Balance was measured by the Brunel balance assessment. Lower extremity motor function was evaluated by the Fugl-Meyer assessment scale. Kinematic data were collected and analyzed using a gait capture system before and after the interventions. Results. Both groups improved on balance and lower extremity motor function measures (P < 0.05), with no significant difference between the two groups after intervention. However, kinematic data were significantly improved (P < 0.05) after BWSTT but not after CT. Maximum hip extension and flexion angles were significantly improved (P < 0.05) for the BWSTT group during the stance and swing phases compared to baseline. Conclusion. In subacute patients with stroke, BWSTT can lead to improved gait quality when compared with conventional gait training. Both methods can improve balance and motor function.

Effect of Virtual Reality on Postural and Balance Control in Patients with Stroke: A Systematic Literature Review

“…Although postural sway is commonly believed to be the basis of feedback system to recalibrate the postural control system relating to the center of gravity, it is debatable whether static balance is related to dynamic balance or functional abilities [42]. Previous studies on body weight supported treadmill training also reported improvement in balance after interventions [43] but did not report significant effect on standing postural sway [44]. The finding from this review challenges the common beliefs that a decrease in postural sway is negatively related to functional improvement.…”

Advanced technology for gait rehabilitation: An overview

“…Body weight-supported treadmill (TM) training (BWSTT) has been proposed and gained a lot of attention for its advantage to allow patients to start training very early in the recovery process (as a result of harness support), to repeat stepping sequences with high intensity and for its advantage to help improving posture and gait pattern. 22 This therapy is exhausting for physical therapists who are needed to assist with lower limbs movements. 23 Robot-assisted gait training (RAGT) -Robotic systems were developed to allow BWS without the need for manual assistance to be provided by the therapist.…”

Rehabilitación de la marcha en el paciente con ictus. Revisión bibliográfica

“…Atendiendo a la puntuación mínima establecida por cada escala para determinar que un estudio tiene una calidad metodológica aceptable (≥ 7 para la escala PEDro, ≥ 3 para la escala Jadad), cinco investigaciones superaron ambas puntuaciones (Combs-Miller et al, 2014;De Paul et al, 2015;Duncan et al, 2011;MacKay-Lyons et al, 2013;Middleton et al, 2014), otras dos (Høyery et al, 2012;Mao et al, 2015;) superaron la puntuación de la escala PEDro pero no la de la escala Jadad y una (Takami & Wakayama, 2010) superó la de la escala Jadad, pero no la de la escala PEDro. Así pues, de los once artículos incluidos en esta revisión, solo tres (Middleton et al, 2014;Ribeiro et al, 2013;Park et al, 2015) no presentaron una calidad metodológica aceptable.…”

“…No obstante, solo se encontraron diferencias estadísticamente significativas en tres trabajos (Combs-Miller et al, 2014;Mao et al, 2015;Langhammer & Stanghelle, 2010).…”