Body weight-supported treadmill training vs. overground walking training for persons with chronic stroke: a pilot randomized controlled trial

Abstract

Objective: To compare the effects of body weight-supported treadmill training and overground walking training when matched for task and dose (duration/frequency/intensity) on improving walking function, activity, and participation after stroke.

Design: Single-blind, pilot randomized controlled trial with three-month follow-up.

Settings: University and community settings.

Subjects: A convenience sample of participants (N = 20) at least six months post-stroke and able to walk independently were recruited.

Interventions: Thirty-minute walking interventions (body weight-supported treadmill training or overground walking training) were administered five times a week for two weeks. Intensity was monitored with the Borg Rating of Perceived Exertion Scale at five-minute increments to maintain a moderate training intensity.

Main measures: Walking speed (comfortable/fast 10-meter walk), walking endurance (6-minute walk), spatiotemporal symmetry, and the ICF Measure of Participation and ACTivity were assessed before, immediately after, and three months following the intervention.

Results: The overground walking training group demonstrated significantly greater improvements in comfortable walking speed compared with the body weight-supported treadmill training group immediately (change of 0.11 m/s vs. 0.06 m/s, respectively; p = 0.047) and three months (change of 0.14 m/s vs. 0.08 m/s, respectively; p = 0.029) after training. Only the overground walking training group significantly improved comfortable walking speed (p = 0.001), aspects of gait symmetry (p = 0.032), and activity (p = 0.003) immediately after training. Gains were maintained at the three-month follow-up (p < 0.05) for all measures except activity. Improvements in participation were not demonstrated.

Conclusion: Overgound walking training was more beneficial than body weight-supported treadmill training at improving self-selected walking speed for the participants in this study.

Keywords: Overground walking; randomized controlled trial; stroke; treadmill training; treatment outcomes.