The Effect of Body Weight Support Treadmill Training on Lower Limb Function in Patients With Chronic Stroke
Condition: Stroke; Gait Disorder, Sensorimotor
MeSH terms: Stroke; Gait Disorders, Neurologic; Body Weight
Study type: Interventional

Summary: 
      Stroke has severe debilitating neurological consequences for the victim. Within context of
      this study, gait disturbance is induced by disabilities in muscle weakness, abnormal muscle
      contraction, or postural control. Gait disturbance has an unfavorable effect on functional
      independence and prognosis of patients. Due to this reason, recovery in gait ability of
      stroke patients is considered as a very important goal in rehabilitation.

      Body weight supported treadmill training (BWSTT) is a task-oriented technique for gait
      restoration after stroke. The present study focused on the possibility of BWSTT as a special
      program for improving gait ability. The purpose of this study was to evaluate the
      effectiveness of a BWSTT intervention useful as a short-term intensive program for chronic
      stroke survivors.
    

Detailed description: 
      Stroke is thought to be a serious health problem which can cause severe disabilities. Aspects
      of disabilities caused by stroke are various according to the affected region and its
      severity. In general, sensory deficits, cognitive problem, motor impairment, visual
      perceptual disorders and dysphagia mainly occur among stroke patients. In particular, gait
      disturbance is induced by disabilities in muscle weakness, abnormal muscle contraction, or
      postural control. This gait disturbance is exhibited as an asymmetric gait pattern, such as a
      decrease in paretic side stance phase and non-paretic swing phase, cadence, velocity and
      difference in step length and stride length. Therefore, these differences create abnormal
      gait patterns in stroke patients. Furthermore, gait disturbance has an unfavorable effect on
      functional independence and prognosis of patients. Due to this reason, recovery in gait
      ability of stroke patients is considered as a very important goal in rehabilitation.

      Gait performance is an indicator of mobility impairment and disability after stroke. It
      predicts mortality, morbidity, and risk of future stroke. Gait speed is responsive to
      short-term rehabilitation. An improvement in gait speed of 0.16 m/s can reduce the level of
      assistance in patients with subacute stroke and was recommended to be the minimum clinically
      significant difference. The control of gait involves the planning and execution from multiple
      cortical areas, such as secondary and premotor cortex. Stroke patients often have gait
      impairment such as decreased gait speed and asymmetrical gait cycle as a result of cortical
      reorganization. Repetitive mass motor task practice had been shown to facilitate
      neuroplasticity and brain reorganization in stroke patients, resulting in enhanced motor
      recovery after stroke.

      Body weight supported treadmill training (BWSTT) is a task-oriented technique for gait
      restoration after stroke. BWSTT has the advantage over conventional therapy as it offers
      higher intensity, more repetitive and task-oriented practice over the same period of time
      when compared to conventional therapy. Several studies have showed that BWSTT was more
      effective in gait speed improvement than regular physiotherapy. It has been demonstrated that
      BWSTT induces changes in corticomotor excitability which lead to improved balance and gait
      performance with chronic stroke. However, other studies have reported that BWSTT was not
      superior to conventional gait training.

      Recent studies have reported that BWSTT can increase walking endurance in the subacute stage
      after stroke, but no improvement was reported in balance and 10 m gait speed. To date, there
      are very few studies that have used gait analysis to show how the improvements in gait
      parameters come about after BWSTT or conventional therapy. There is still a lack of basic
      understanding of gait training on human locomotion.

      Despite substantial recovery of independent ambulation by survivors following unilateral
      stroke, persistent gait abnormalities are observed in a large percentage of these persons. In
      these circumstances, a short-term intermittent and intensive rehabilitation program for
      chronic stroke survivors is thought to be particularly efficient for shoring up their
      independence, and the present study focused on the possibility of BWSTT as a special program
      for improving gait ability. The purpose of this study was to evaluate the effectiveness of a
      BWSTT intervention useful as a short-term intensive program for chronic stroke survivors.
    

Intervention name(s): Body weight support treadmill training + conventional therapy; Conventional therapy
Intervention type(s): Other; Other
Intervention description(s): Conventional gait therapy was done based on the principles of the proprioceptive neuromuscular facilitation (PNF) and Motor Relearning program (MRP) concepts.
Patients in intervention arm were additionally trained with a 40% body weight support and a comfortable walking speed on treadmill for twenty minutes. The training, which was conducted three times a week, for period of two weeks.; Conventional gait therapy was done based on the principles of the proprioceptive neuromuscular facilitation (PNF) and Motor Relearning program (MRP) concepts.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Rehabilitation; Body weight supported treadmill training