Effectiveness of Body-Weight-Supported Treadmill Training in Improving Quality of Gait among Stroke Survivors: A Narrative Review

Abstract

Regaining the ability to walk after a stroke improves self-esteem and quality of life of the survivor and as such restoring gait is an optimal goal of  stroke rehabilitation requiring different approaches. The purpose of this article was to review the effectiveness of bodyweight- supported treadmill  (BWST) training in improving gait quality post stroke. An exhaustive electronic search was conducted in Google Scholar, PEDro and PubMed  databases for studies (from 1999 to 2019) on the effectiveness of BWST training in improving quality of gait among patients with stroke. Included  studies were those published in English language, conducted on stroke patients using treadmill as the primary intervention to assess gait  parameters. Of the 26,237 articles identified from the overall search, only 9 articles met the inclusion criteria and were independently screened and  reviewed. The results showed that BWST training could elicit significant improvement in cadence (range: 3.2 to 4.2% gait cycle), paretic step length  (6.7 cm), walking speed (p < 0.02) and walking capacity (p < 0.001). While walking velocity increased by 22%, stride length increased by 13% and a  medium to large effect sizes of 0.7 and 1.16 standard deviation units were observed for gait energy expenditure. A significant improvement in  walking speed and walking distance (p < 0.005) which remained better after follow-up (mean difference 0.22 m/sec, 95% CI 0.05 to 0.39) was  observed. It was concluded that BWST training is effective in improving quality of gait and in enhancing functional recovery of stroke survivors.