Is there influence of the load addition during treadmill training on cardiovascular parameters and gait performance in patients with stroke? A randomized clinical trial (original) (raw)
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Archives of Physical Medicine and Rehabilitation, 2016
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 (NZ28) with chronic stroke (>6mo from the stroke event). Interventions: Participants were randomly assigned to receive gait training with BWS on a treadmill (nZ14) or overground (nZ14) 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 (PZ.01 and PZ.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.
BioMed Research International, 2015
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...
Treadmill-Based Locomotor Training with Leg Weights in People with Chronic Stroke
Research Journal of Pharmacy and Technology, 2017
Background and Purpose: Novel locomotor training strategies for individuals with disorders of the central nervous system have been associated with improved locomotor function. The purpose of this study was to investigate the effects of treadmill-based locomotor training combined with leg weights on functional ambulation in individuals with chronic stroke. We assessed functional ambulation and muscle activity in ambulatory individuals with chronic stroke. Methods: We used a pre/posttest design. Six individuals with chronic stroke who were community ambulators were recruited. Participants underwent a 30-minute treadmill-based locomotor training sessions three times per week for four to 12 weeks. The training program involved treadmill walking for 30 minutes with partial body weight support as needed. Leg weights, equivalent to 5% of body weight, were affixed around the paretic leg. Outcome measures consisted of the 10-m walk test, the modified Emory Functional Ambulation Profile, and temporal gait parameters. Results: Improvements were observed in functional ambulation measures, particularly the stairs subscore of the modified Emory Functional Ambulation Profile. Participants also exhibited an increase in the proportion of time the paretic leg spent in swing. No significant improvements were observed in the 10-m walk test. Conclusions: This pilot study demonstrates that the combination of leg weights and treadmill training is a feasible approach, that is well tolerated by participants. This approach may have the potential to improve some aspects of functional ambulation and the performance of activities requiring hip and knee flexion.
The Journal of Rehabilitation Research and Development, 2008
The effects of task-repetitive locomotor training on stroke patients' spatial and temporal gait parameters during unassisted walking are not well understood. This study determined the effects of treadmill aerobic exercise (T-EX) on spatial and temporal gait parameters that underlie changes in overground walking function. Thirty-nine subjects with hemiparetic stroke underwent T-EX three times weekly for 6 months. We measured the subjects pre-and posttraining on 30-foot timed walks and 6-minute distance walks with usual assistive devices and on an 8 m instrumented walkway without assistive devices. T-EX improved 30-foot walks by 17% and 6-minute walks by 23%. Unassisted walking velocity increased 22%, stride length increased 13%, and cadence increased 7%. Paretic and nonparetic step lengths increased significantly, and respective step times decreased significantly. Interlimb symmetry did not change. This study presents preliminary evidence that changes in spatial and temporal gait parameters contribute to the increased velocity of subjects with stroke after T-EX.
Effects of gait training with horizontal impeding force on gait and balance of stroke patients
Journal of physical therapy science, 2015
The purpose of this study was to investigate the effects of treadmill training with a horizontal impeding force applied to the center of upper body mass on the gait and balance of post-stroke patients. [Subjects and Methods] Twenty-four subjects with hemiplegia less than 3 months after stroke onset were randomly assigned to 2 groups: an applied horizontal impeding force on treadmill training (experimental) group (n = 12), and a control group (n = 12). Both groups walked on a treadmill at a comfortable or moderate speed for 20 minutes per day, 3 sessions per week for 8 weeks after a pre-test. The experimental group also had a horizontal impeding force applied to the center of their upper body mass. [Results] All groups demonstrated significant improvement after 8 weeks compared to baseline measurements. In intra-group comparisons, the subjects' gait ability (CGS, MGS, cadence, and step length) and balance ability (TUG, BBS, and FRT) significantly improved. In inter-group comparisons, the experimental group's improvement was significantly better in CGS MGS, cadence, step length, TUG, and BBS, but not in FRT. [Conclusion] Treadmill training was identified as an effective training method that improved gait and balance ability. A horizontal impeding force applied during treadmill training was more effective than treadmill walking training alone at improving the gait and dynamic balance of patients with stroke.
Stroke, 1998
Background and Purpose —A new gait training strategy for patients with stroke proposes to support a percentage of the patient’s body weight while retraining gait on a treadmill. This research project intended to compare the effects of gait training with body weight support (BWS) and with no body weight support (no-BWS) on clinical outcome measures for patients with stroke. Methods —One hundred subjects with stroke were randomized to receive one of two treatments while walking on a treadmill: 50 subjects were trained to walk with up to 40% of their body weight supported by a BWS system with overhead harness (BWS group), and the other 50 subjects were trained to walk bearing full weight on their lower extremities (no-BWS group). Treatment outcomes were assessed on the basis of functional balance, motor recovery, overground walking speed, and overground walking endurance. Results —After a 6-week training period, the BWS group scored significantly higher than the no-BWS group for functi...
Brain Sciences
Background: Lower body positive pressure (LBPP) may provide a novel intervention for gait training in neurological conditions. Nonetheless, studies investigating the safety and feasibility of LBPP in patients with stroke are insufficient. Objectives: The purpose of this study was to evaluate the safety and feasibility of LBPP as a rehabilitation intervention for individuals with chronic stroke. Methods: Individuals with chronic stroke were recruited from the community to participate in LBPP gait training three times a week for six weeks. The LBPP’s safety and feasibility were documented throughout the study and at the end of six weeks. Safety and feasibility referred to the incidence of adverse events, complications, the participant and therapist satisfaction questionnaire, and the device limitation including but not limited to technical issues and physical constraints. In addition, blood pressure, pulse rate, and oxygen saturation were taken pre- and post-session. Dependent t-tests...
Topics in Stroke Rehabilitation, 2014
Background: Body weight-supported treadmill training (BWSTT) has produced mixed results compared with other therapeutic techniques. Objective: The purpose of this study was to determine whether an intensive intervention (intensive mobility training) including BWSTT provides superior gait, balance, and mobility outcomes compared with a similar intervention with overground gait training in place of BWSTT. Methods: Forty-three individuals with chronic stroke (mean [SD] age, 61.5 [13.5] years; mean [SD] time since stroke, 3.3 [3.8] years), were randomized to a treatment (BWSTT, n = 23) or control (overground gait training, n = 20) group. Treatment consisted of 1 hour of gait training; 1 hour of balance activities; and 1 hour of strength, range of motion, and coordination for 10 consecutive weekdays (30 hours). Assessments (step length differential, self-selected and fast walking speed, 6-minute walk test, Berg Balance Scale [BBS], Dynamic Gait Index [DGI], Activities-specifi c Balance Confi dence [ABC] scale, single limb stance, Timed Up and Go [TUG], Fugl-Meyer [FM]