Step training with body weight support: effect of treadmill speed and practice paradigms on poststroke locomotor recovery.
OBJECTIVE
To investigate the effect of practice paradigms that varied treadmill speed during step training with body weight support in subjects with chronic hemiparesis after stroke.


METHODS
Randomized, repeated-measures pilot study with 1- and 3-month follow-ups.


METHODS
Outpatient locomotor laboratory.


METHODS
Twenty-four individuals with hemiparetic gait deficits whose walking speeds were at least 50% below normal.


METHODS
Participants were stratified by locomotor severity based on initial walking velocity and randomly assigned to treadmill training at slow (0.5mph), fast (2.0mph), or variable (0.5, 1.0, 1.5, 2.0mph) speeds. Participants received 20 minutes of training per session for 12 sessions over 4 weeks.


METHODS
Self-selected overground walking velocity (SSV) was assessed at the onset, middle, and end of training, and 1 and 3 months later.


RESULTS
SSV improved in all groups compared with baseline (P<.001). All groups increased SSV in the 1-month follow-up (P<.01) and maintained these gains at the 3-month follow-up (P=.77). The greatest improvement in SSV across training occurred with fast training speeds compared with the slow and variable groups combined (P=.04). Effect size (ES) was large between fast compared with slow (ES=.75) and variable groups (ES=.73).


CONCLUSIONS
Training at speeds comparable with normal walking velocity was more effective in improving SSV than training at speeds at or below the patient's typical overground walking velocity.
Sullivan
Katherine J
KJ
Department of Neurology, University of California, Los Angeles, CA 90095, USA.
Knowlton
Barbara J
BJ
Dobkin
Bruce H
BH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight / Q000502:physiology*; D002908:Chronic Disease; D005080:Exercise Test; D005260:Female; D005684:Gait / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation*; D010865:Pilot Projects; D011214:Practice, Psychological; D011237:Predictive Value of Tests; D020127:Recovery of Function / Q000502:physiology*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016138:Walking / Q000502:physiology*