Body Weight–Supported Treadmill Training Is No Better Than Overground Training for Individuals with Chronic Stroke: A Randomized Controlled Trial

So in the past 6 years has your hospital discontinued BWSTT? Do you prefer your hospital incompetence to be: NOT KNOWING, or NOT DOING?

Body Weight–Supported Treadmill Training Is No Better Than Overground Training for Individuals with Chronic Stroke: A Randomized Controlled Trial

Topics in Stroke Rehabilitation, 2014

Addie Middleton, DPT,
1
 Angela Merlo-Rains, PhD, DPT,
 2
 Denise M. Peters, DPT,
1
 Jennifaye V. Greene, PhD, MS, PT, NCS,
1
 Erika L. Blanck, DPT, ATC,
 3
 Robert Moran, PhD,
4
 and Stacy L. Fritz, PhD, PT
1
1
Department of Exercise Science, Physical Therapy Program, University of South Carolina, Columbia, South Carolina;
 2
College of Health and Human Services, Physical Therapy Program, Northern Arizona University, Phoenix, Arizona;
3
Department of Cell Biology and  Anatomy, University of South Carolina, School of Medicine, Columbia, South Carolina;
4
Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
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 post test 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.
Key words:
balance, gait, mobility, rehabilitation, stroke, treadmill training