Pressure-controlled treadmill training in chronic stroke: a case study with AlterG.
OBJECTIVE
Body-weight-supported treadmill training has been shown to be an effective intervention to improve walking characteristics for individuals who have experienced a stroke. A pressure-controlled treadmill utilizes a sealed chamber in which air pressure can be altered in a controlled manner to counteract the effects of gravity. The focus of this case study was to assess the immediate and short-term impact of a pressure-controlled treadmill to improve gait parameters, reduce fall risk, improve participation, and reduce the self-perceived negative impact of stroke in an individual with chronic stroke.


METHODS
The subject was an 81-year-old man (14.5 months poststroke). He had slow walking speed, poor endurance, and multiple gait deviations.


METHODS
The subject trained 4 times per week for 4 weeks (40 minutes per session) on a pressure-controlled treadmill (AlterG M320) to counter the influence of gravity on the lower extremities.


RESULTS
Following training, self-selected gait speed increased from 0.50 m/s to 0.96 m/s, as measured by the 10-meter walk test. Stride length increased from 0.58 m to 0.95 m after training and to 1.00 m at 1-month follow-up. Peak hip flexion increased from 3.7° to 24.6° after training and to 19.4° at 1-month follow-up. Peak knee flexion increased from 19.4° to 34.3° after training and to 42.7° at 1-month follow-up. Measures of endurance, fall risk, and percentage of perceived recovery also were found to improve posttraining.


CONCLUSIONS
Training with a pressure-controlled treadmill may be a viable alternative to traditional body-weight-supported treadmill training for persons poststroke. Additional studies with larger sample sizes are needed to elucidate the role of pressure-controlled treadmill training in this population. Video abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A97).
Clinical Faculty and Clinical Physical Therapy (CL), Keck Medical Center of USC, Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles; Rancho Los Amigos National Rehabilitation Center (AM), Downey, California; Musculoskeletal Biomechanics Research Laboratory (JB), University of Southern California, Los Angeles; Biokinesiology and Musculoskeletal Biomechanics Research Lab (CMP), Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles; and Clinical Physical Therapy and Neuroplasticity and Imaging Laboratory (BEF), Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles.
Cherise
C
Lathan
Andrew
A
Myler
Jennifer
J
Bagwell
Christopher M
CM
Powers
Beth E
BE
Fisher
D000369:Aged, 80 and over; D002908:Chronic Disease; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods*; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D020521:Stroke / Q000209:etiology; D000071939:Stroke Rehabilitation