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(Stroke. 2009;40:3079.)
© 2009 American Heart Association, Inc.

Original Contributions

Walking After Stroke: What Does Treadmill Training With Body Weight Support Add to Overground Gait Training in Patients Early After Stroke?

A Single-Blind, Randomized, Controlled Trial

Marco Franceschini, MD; Stefano Carda, MD; Maurizio Agosti, PT; Roberto Antenucci, MD; Daniele Malgrati, MD; Carlo Cisari, MD on behalf of Gruppo Italiano Studio Allevio Carico Ictus (GISACI)

From IRCCS San Raffaele Pisana (M.F.), Rome, Italy; the Department of Clinical & Experimental Medicine, Division of Physical & Rehabilitative Medicine (S.C., C.C.), University of Eastern Piedmont "A. Avogadro," Novara, Italy; the Department of Rehabilitative Medicine (M.A.), University Hospital Parma, Parma, Italy; the Rehabilitation Unit (R.A.), Piacenza and Borgonovo Valtidone Hospital, Italy; and the Rehabilitation Unit (D.M.), S. Francesco Clinic, Bergamo, Italy.

Correspondence to Marco Franceschini, MD, IRCCS San Raffaele Pisana, via della Pisana 235, 00163, Rome, Italy. E-mail marco_franceschini{at}hotmail.com

Background and Purpose— This study aimed to assess the effectiveness of gait training using body weight support on a treadmill compared with conventional gait training for people with subacute stroke who were unable to walk.

Methods— This was a single-blind, randomized, controlled trial with a 6-month follow-up. Ninety-seven subjects were recruited within 6 weeks of stroke onset and were randomly assigned to conventional rehabilitative treatment plus gait training with body weight support on a treadmill (experimental group; n=52) and conventional treatment with overground gait training only (control group; n=45). All subjects were treated in 60-minute sessions every weekday for 4 weeks. Outcome measures were Motricity Index, Trunk Control test, Barthel Index, Functional Ambulation Categories, 10-meter and 6-minute Walk Tests, and Walking Handicap Scale. Assessments were made at baseline, after 20 sessions of treatment, 2 weeks after treatment, and 6 months after stroke.

Results— After treatment, all patients were able to walk. Both groups showed improvement in all outcome measures (P<0.0063) at the end of the treatment and at follow-up. No differences were seen between the 2 groups before, during, and after treatment and at follow-up.

Conclusions— In subacute patients with stroke, gait training on a treadmill with body weight support is feasible and as effective as conventional gait training. However, the need for more personnel for treadmill training makes the use of robotically assisted systems more compelling.

Key Words: exercise therapy • gait • rehabilitation • stroke