Background: The diagnosis of CVA is one of the most commonly seen diagnoses in the inpatient rehabilitation setting, and hemiparesis (weakness of one side of the body) is present in over 80% of people who have suffered a stroke. One of the main goals of physical therapy reported by CVA patients is to be able to walk again, making gait training a main focus for physical therapists when working with stroke patients. Therefore, the selection of the type of intervention for gait training is essential. Commonly used interventions for gait training in stroke patients are overground training and treadmill training. Purpose: The purpose of this literature review is find which type of intervention for gait training provides the best functional outcomes for stroke patients. More specifically, answering the following question is of interest: 'In patients within 1 year of having a stroke, how effective is over-ground gait training compared to treadmill training in promoting functional outcomes?" Case description: This patient is a 75 y/o female who suffered a left ischemic cerebral vascular accident (CVA) (frontal/parietal region). Patient presented with right sided hemiparesis. Upon initial evaluation, distance travelled for ambulation was 5 feet with 2 person bilateral hand held assist (Max assist). Patient demonstrated excessive right knee hyperextension, and assistance for right LE limb advancement, as well as slight inversion tendency of right ankle/foot during stance phase. Outcomes: One method was not found to be superior over the other, and both gait training methods proved to be statistically significant in improving overall gait pattern and velocity. Discussion: Both treadmill and overground gait training have been shown to improve gait velocity, balance, gait symmetry (including step/stride length and stance time), and endurance (both statistically significant). Treadmill training has been shown to improve gait symmetry and velocity more than overground training, but results were not statistically significant between groups concluding that both methods of training are equally beneficial.
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Treadmill, Overground, Stroke, Gait
Hines, Stephanie. "Treadmill vs. Overground Training for Stroke Patients." (2014). http://digitalrepository.unm.edu/dpt/74