Purpose: This project presented a patient with rightsided hemiparesis following stroke and used evidence-based analysis to answer the PICO question: Is body-weight-supported treadmill training more effective than overground gait training at improving the functional gait parameters of speed and endurance in acute patients post-stroke? Background: Regaining independent ambulation is a common goal for stroke patients. Two of the most common methods of retraining gait are overground walking and body-weight-supported treadmill training (BWSTT), however there is little consensus about which method is superior and for what stroke population. Case Description: Ms. S presented with multiple leftsided infarcts resulting in right hemiparesis of the upper and lower extremities, reduced trunk control, and speech difficulties. On admission to rehabilitation she was essentially non-ambulatory. Outcomes: When matched for volume and intensity, body-weight-supported treadmill training and overground gait training provide similar benefits to patients. In ambulatory stroke patients, overground training added a degree of specificity that was superior. In low-functioning patients, BWSTT was superior for increased safety and ability to provide higher volume training and better cardiovascular conditioning. Discussion: For a patient such as Ms. S, who presented with co-morbidities lowering her baseline activity tolerance, use of the body-weight-supported treadmill for relearning of gait and to improve her cardiovascular endurance would be superior to overground training because she would regain independence with gait and also improve endurance for other functional activities.
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Exercise Therapy; Lower Extremity; Stroke
Cover, Heather M.. "Is Body-Weight-Supported Treadmill Training More Effective Than Overground Gait Training at Improving the Functional Gait Parameters of Speed and Endurance in Acute Patients Post-Stroke?." (2016). https://digitalrepository.unm.edu/dpt/16
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