Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2014 Nov-Dec;21(6):462-76.
doi: 10.1310/tsr2106-462.

Body weight-supported treadmill training is no better than overground training for individuals with chronic stroke: a randomized controlled trial

Addie Middleton  1 , Angela Merlo-Rains  2 , Denise M Peters  1 , Jennifaye V Greene  1 , Erika L Blanck  3 , Robert Moran  4 , Stacy L Fritz  1
Affiliations
Randomized Controlled Trial

Body weight-supported treadmill training is no better than overground training for individuals with chronic stroke: a randomized controlled trial

Addie Middleton et al. Top Stroke Rehabil. 2014 Nov-Dec.

Abstract

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-specific Balance Confidence [ABC] scale, single limb stance, Timed Up and Go [TUG], Fugl-Meyer [FM], and perceived recovery [PR]) were conducted before, immediately after, and 3 months after intervention.

Results: No significant differences (α = 0.05) were found between groups after training or at follow-up; therefore, groups were combined for remaining analyses. Significant differences (α = 0.05) were found pretest to posttest for fast walking speed, BBS, DGI, ABC, TUG, FM, and PR. DGI, ABC, TUG, and PR results remained significant at follow-up. Effect sizes were small to moderate in the direction of improvement.

Conclusions: Future studies should investigate the effectiveness of intensive interventions of durations greater than 10 days for improving gait, balance, and mobility in individuals with chronic stroke.

Keywords: balance; gait; mobility; rehabilitation; stroke; treadmill training.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: The authors have no conflicts of interest to report.

Figures

Figure 1
Figure 1
Delivery of treatment components by group. BWSTT = body weight–supported treadmill training; ROM = range of motion.
Figure 2
Figure 2
Consolidated Standards of Reporting Trials (CONSORT) diagram showing flow of participants through each stage of this randomized trial. *Participants screened and randomly assigned to groups because of initial interest but unable to participate because of scheduling, transportation, or personal or family health issues. Intervention not initiated.
Figure 3
Figure 3
Changes across testing sessions represented as percentages of total possible score. ABC = Activities-specific Balance Confidence Scale; Base = baseline assessment period; BBS = Berg Balance Scale; DGI = Dynamic Gait Index; FM-LE = Fugl-Meyer Lower Extremity subscale; Post = posttest assessment period; Pre = pretest assessment period; SIS = Stroke Impact Scale. Standard errors for included outcome measures are presented in Table 3.
Figure 4
Figure 4
Percentage of participants meeting or exceeding minimal detectable change (MDC). MDCs for included outcome measures are presented in Table 2 (Methods). 3WMT = 3-meter walk test; 6MWT = 6-minute walk test; ABC = Activities-specific Balance Confidence Scale; BBS = Berg Balance Scale; DGI = Dynamic Gait Index; FM-LE = Fugl-Meyer Lower Extremity subscale; SLS = single limb stance; TUG = Timed Up and Go.
See this image and copyright information in PMC

References

    1. Combs SA, Dugan EL, Ozimek EN, Curtis AB. Bilateral coordination and gait symmetry after body-weight supported treadmill training for persons with chronic stroke. Clin Biomech (Bristol, Avon) 2013;28(4):448–453. - PubMed
    1. da Cunha IT, Jr, Lim PA, Qureshy H, Henson H, Monga T, Protas EJ. Gait outcomes after acute stroke rehabilitation with supported treadmill ambulation training: A randomized controlled pilot study. Arch Phys Med Rehabil. 2002;83(9):1258–1265. - PubMed
    1. Hornby TG, Campbell DD, Kahn JH, Demott T, Moore JL, Roth HR. Enhanced gait-related improvements after therapist-versus robotic-assisted locomotor training in subjects with chronic stroke: A randomized controlled study. Stroke. 2008;39(6):1786–1792. - PubMed
    1. Kosak MC, Reding MJ. Comparison of partial body weight-supported treadmill gait training versus aggressive bracing assisted walking post stroke. Neurorehabil Neural Repair. 2000;14(1):13–19. - PubMed
    1. Moore JL, Roth EJ, Killian C, Hornby TG. Locomotor training improves daily stepping activity and gait efficiency in individuals poststroke who have reached a “plateau” in recovery. Stroke. 2010;41(1):129–135. - PubMed

Publication types