Walking and balance outcomes for stroke survivors: a randomized clinical trial comparing body-weight-supported treadmill training with versus without challenging mobility skills

But what about all these other treadmills? Don't you believe in testing the complete universe of treadmills? Or too lazy to do them all?  So once again we will need followup research to identify the best intervention via treadmill. What a fucking waste just because we have NO stroke leadership and NO stroke strategy.

Stroke Rehabilitation and the AlterG - Anti-gravity treadmill

 

The treadmill bike!?

 

air pressure treadmill 

 

Turning-Based Treadmill 

 

Air pressure treadmill instantly sheds 80% of your weight

 

underwater treadmill

 

Split Belt Treadmill 

 

rotating treadmill

 

Walking and balance outcomes for stroke survivors: a randomized clinical trial comparing body-weight-supported treadmill training with versus without challenging mobility skills 

 

• Sarah A. GrahamEmail authorView ORCID ID profile,
• Elliot J. Roth and
• David A. Brown

Journal of NeuroEngineering and Rehabilitation201815:92

https://doi.org/10.1186/s12984-018-0442-3

©  The Author(s). 2018

• Received: 16 January 2018
• Accepted: 18 October 2018
• Published: 1 November 2018

Abstract

Background

Treadmill training, with or without body-weight support (BWSTT), typically involves high step count, faster walking speed, and higher heart-rate intensity than overground walking training. The addition of challenging mobility skill practice may offer increased opportunities to improve walking and balance skills. Here we compare walking and balance outcomes of chronic stroke survivors performing BWSTT with BWSTT including challenging mobility skills.

Methods

Single-blind randomized clinical trial comparing two BWSTT interventions performed in a rehabilitation research laboratory facility over 6 weeks. Participants were 18+ years of age with chronic (≥5 months) poststroke hemiparesis due to a cortical or subcortical ischemic or hemorrhagic stroke and walking speeds < 1.1 m/s at baseline. A hands-free group (HF; n = 15) performed BWSTT without assistance from handrails or assistive devices, and a hands-free plus challenge group (HF + C; n = 14) performed the same protocol while additionally practicing challenging mobility skills. The primary outcome was change in comfortable walking speed (CWS), with secondary outcomes of fast walk speed (FWS), six-minute walk distance, Berg Balance Scale (BBS) scores, and Activities Specific Balance Confidence (ABC) scores.

Results

Significant pre-post improvement of CWS (Z = − 4.2, p ≤ 0.0001) from a median of 0.35 m/s (range 0.10 to 1.09) to a median of 0.54 m/s (range 0.1 to 1.17), but no difference observed between groups (U = 96.0, p = 0.69). Pre-post improvements across all participants resulted in reclassified baseline ambulation status from sixteen to ten household ambulators, three to seven limited community ambulators, and ten to twelve community ambulators. Secondary outcomes showed similar pre-post improvements with no between-group differences.

Conclusions

The addition of challenging mobility skills to a hands-free BWSTT protocol did not lead to greater improvements in CWS following 6 weeks of training. One reason for lack of group differences may be that both groups were adequately challenged by walking in an active, self-driven treadmill environment without use of handrails or assistive devices.

Trial registration

NCT02787759 Falls-based Training for Walking Post-Stroke (FBT); retrospectively registered June 1st, 2016.