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Body weight supported treadmill training versus traditional training in patients dependent on walking assistance after stroke: a randomized controlled trial

Purpose: Treadmill training with body weight support (TTBWS) for relearning walking ability after brain damage is an approach under current investigation. Efficiency of this method beyond traditional training is lacking evidence, especially in patients needing walking assistance after stroke. The objective of this study was to investigate change in walking and transfer abilities, comparing TTBWS with traditional walking training. Methods: A single-blinded, randomized controlled trial was conducted. Sixty patients referred for multi-disciplinary primary rehabilitation were assigned into one of two intervention groups, one received 30 sessions of TTBWS plus traditional training, the other traditional training alone. Daily training was 1 hr. Outcome measures were Functional Ambulation Categories (FAC), Walking, Functional Independence Measure (FIM); shorter transfer and stairs, 10 m and 6-min walk tests. Results: Substantial improvements in walking and transfer were shown within both groups after 5 and 11 weeks of intervention. Overall no statistical significant differences were found between the groups, but 12 of 17 physical measures tended to show improvements in favour of the treadmill approach. Conclusions: Both training strategies provided significant improvements in the tested activities, suggesting that similar outcomes can be obtained in the two modalities by systematic, intensive and goal directed training. Implications for Rehabilitation Treadmill training with body weight support (TTBWS) and traditional gait training were found to be equally effective in improving walking and transfer in patients dependent on walking assistance after stroke. However, most outcome measures showed a tendency of improvement in favour of the treadmill group. Both training modalities were systematic, goal-directed and intensive, and the time used for training was the same. The choice between the two equally effective training alternatives should be based on the patients’ preference, and availability of equipment and resources.