Effect of Underwater Treadmill Gait Training With Water-Jet Resistance on Balance and Gait Ability in Patients With Chronic Stroke: A Randomized Controlled Pilot Trial

Effectiveness of an 8-week overground walking with paretic lower limb loading on spatiotemporal gait parameters and motor function among chronic stroke survivors: a protocol for randomised controlled trial

BACKGROUND

Post-stroke gait deviations contribute to significant functional disability, impaired walking ability and poor quality of life. Prior studies suggest that gait training with paretic lower limb loading may improve gait parameters and walking ability in post-stroke. However, most gait training methods used in these studies are not readily available, and studies using cheaper methods are limited.

OBJECTIVE

The purpose of this study is to describe a protocol for a randomised controlled trial on the effectiveness of an 8-week overground walking with paretic lower limb loading on spatiotemporal gait parameters and motor function among chronic stroke survivors.

METHODS

This is a two-center, single-blind, two-arm parallel randomised controlled trial. Forty-eight stroke survivors with mild to moderate disability will be recruited from two tertiary facilities and randomly assigned into two intervention arms; overground walking with paretic lower limb loading or overground walking without paretic lower limb loading in a 1:1 ratio. All interventions will be administered thrice weekly for 8 weeks. Primary outcomes will be step length and gait speed whereas the secondary outcomes will include step length symmetry ratio, stride length, stride length symmetry ratio, stride width, cadence and motor function. All outcomes will be assessed at baseline, 4, 8 and 20 weeks after the start of intervention.

DISCUSSION

This will be the first randomised controlled trial to report the effects of overground walking with paretic lower limb loading on spatiotemporal gait parameters and motor function among chronic stroke survivors from low-resource setting.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05097391. Registered on 27 October 2021.

The effect of backward walking observational training on gait parameters and balance in chronic stroke: randomized controlled study

BACKGROUND

Backward walking (BW) and action observation training may potentially help people at risk of falls. Moreover, action observation training could be a potential intervention to improve gait after a stroke.

AIM

We aimed to identify the effects of BW action observational training (BWOT) on gait parameters and balance in chronic stroke patients.

DESIGN

Randomized, controlled study.

SETTING

Rehabilitation center.

POPULATION

Twenty-four chronic stroke patients were randomly assigned to BWOT (N.=12) and landscape observational training (LOT) (N.=12) groups.

METHODS

The BWOT group performed BW after watching a video of a BW, while the LOT group performed BW training after watching a video of a landscape. Both groups received traditional therapy for 5 days per week and BWOT for 3 days a week for 4 weeks. The primary and secondary outcomes were gait and balance, respectively. Static balance was measured using the 5 Times Sit-To-Stand Test (5TSTS), the center of pressure (COP) displacement, and weight distribution (WD) of the affected side. Dynamic balance was measured using the activity-specific balance confidence (ABC) scale.

RESULTS

The BWOT group showed significant improvements in gait velocity (p=0.001, η²=0.470), step length (P=0.007, η²=0.313), stride lengths (P<0.002, η²=0.431), 5TSTS (P=0.021, η²=0.231), COP velocity (P=0.022, η²=0.226), length (P=0.001, η²=0.504), WD of the affected side (P=0.033, η²=0.193), and ABC score (P=0.023, η²=0.226) than the LOT group.

CONCLUSIONS

The 4-week BWOT training program significantly improved the gait parameters and static and dynamic balance in stroke patients.

CLINICAL REHABILITATION IMPACT

BWOT is an accessible and effective method of rehabilitation training that can also be applied to conventional therapy as a useful method for improving the gait and balance after stroke.