A randomized controlled trial on the efficacy of body weight support overground ambulation versus body weight support treadmill training among post-stroke patients of a tertiary hospital

Objective: To establish the efficacy of body weight support overground ambulation over body weight support treadmill training in the recovery of post-stroke patients. Design: Randomized, single-blinded controlled trial. Setting: Physical therapy gym of the department of rehabilitation medicine. Participants: Of 205 stroke subjects, 102 were assigned randomly to the body weight support overground (BWS-O) ambulation training group, and 103 were assigned to the body weight support treadmill (BWS-T) training group. Interventions: Subjects were randomly assigned either to BWS-O or BWS-T group. Participants in the study were gait trained using a body weight support (BWS) overhead harness system provided with up to 40% of their body weight supported at the beginning of the training. Treadmill speed in the BWS-T group was initially started with 0.5 mph. Progression was accomplished by decreasing percentage of body weight support or increasing treadmill speed based on gait pattern and endurance. Main Outcome Measures: Study outcome measures included balance using the BERG Balance Scale, cadence and 10-meter walking speed. Results: After an 8 week study period, both BWS-O and BWS-T groups showed an improvement in terms of the BERG Balance Scale, cadence and 10-meter walking speed. However, the BWS-O group was noted to have a statistical improvement in terms of the BERG Balance Scale and cadence on the 4th week up to 8th week follow up as compared to BWS-T. In terms of 10-meter walking speed, the BWS-O group showed an insignificant difference with BWS-T group on the 8th week follow up. Conclusions: The use of body weight support overground ambulation training produced a better outcome in post-stroke patients in terms of balance, cadence and 10-meter walking speed. This technique is promising in that it can be recommended as part of rehabilitation management program of post-stroke patients.