The effectiveness of body weight-supported gait training and floor walking in patients with chronic stroke

Objective: To compare body weight-supported exercise on a gait trainer with walking exercise overground. Design: Randomized controlled trial. Setting: Rehabilitation hospital. Participants: Forty-five ambulatory patients with chronic stroke. Interventions: Patients were randomized to 3 groups: (1) gait trainer exercise with functional electric stimulation (GT(stim)), (2) gait trainer exercise without stimulation (GT), and (3) walking overground (WALK). All patients practiced gait for 15 sessions during 3 weeks (each session, 20min), and they received additional physiotherapy 55 minutes daily. Main Outcome Measures: Ten-meter walk test (10MWT), six-minute walk test (6MWT), lower-limb spasticity and muscle force, postural sway tests, Modified Motor Assessment Scale (MMAS), and FIM instrument scores were recorded before, during, and after the rehabilitation and at 6 months follow-up. Results: The mean walking distance using the gait trainer was 6900 +/- 1200m in the GT(stim) group and 6500 +/- 1700m in GT group. In the WALK group, the distance was 4800 +/- 2800m, which was less than the walking distance obtained in the GT(stim) group (P=.027). The body-weight support was individually reduced from 30% to 9% of the body weight over the course of the program. In the pooled 45 patients, the 10MWT (P <.001), 6MWT (P <.001), MMAS (P <.001), dynamic balance test time (P <.001), and test trip (P=.005) scores improved; however, no differences were found between the groups. Conclusions: Both the body weight-supported training and walking exercise training programs resulted in faster gait after the intensive rehabilitation program. Patients' motor performance remained improved at the follow-up.