Authors (including presenting author) :
Li SM(1), Chow PY(1), Wu H(1), Cheung YW(1)
Affiliation :
(1)Physiotherapy Department, Tseung Kwan O Hospital, Hong Kong
Introduction :
Stroke survivors often suffer from lower limbs weakness and gait impairment. Treadmill training is commonly used to improve walking speed, endurance and ambulatory independence. However, traditional body weight supported treadmill via harness system may create discomfort over the groin area and hinder the blood circulation altering gait kinematics and difficult for prolonged use. Ordinary treadmill cannot provide visual feedback during training, stroke patients may have difficulties understanding instruction on normal gait pattern. In that situation, manual guidance from therapist may be needed. Anti-gravity treadmill has become popular in post-operative rehabilitation allowing individual to walk or run with less pain and ground reaction force while providing immediate visual feedback on his/her lower extremities. Resembling moonwalk, Anti-gravity treadmill training has been shown to effectively unload the lower body of the individual without the negative drawbacks mentioned or altering the gait pattern in knee osteoarthritis and lower extremity surgery patients. The positive pressure inside the waist-high chamber increases to produce an upward force for unweighting the individual.
Objectives :
This study sought to evaluate the safety and effectiveness of Anti-gravity treadmill in stroke rehabilitation.
Methodology :
Stroke patients who suffered from a first, single stroke less than 6 months were recruited from the Neurology Rehabilitation Program (NRP) in Tseung Kwan O Hospital between December 2019 and November 2020. 20-24 sessions of 15-20 minutes gait training on Anti-gravity were provided. Approximate 20-30% of body weight were supported. Patient’s safety, 6 Minutes Walk Test (6MWT) distance, Five Times Sit To Stand (FTSTS) and Functional Ambulation Category (FAC) were measured at baseline and at end of the rehabilitation.
Result & Outcome :
Nine patients (7 men) with a mean age of 50.11 years (SD=11.89) and a mean weight of 70.01 kg (SD=11.07) received Anti-gravity treadmill training. No adverse events were reported in relation to Anti-gravity treadmill. There were significant improvement in 6MWT distance (304.67±65.21 vs 407.67±64.32; p=0.008), FTSTS (12.61±4.43 vs 9.32±1.57; p=0.008) and FAC (1-4 vs 4-5; p=0.010).
Anti-gravity treadmill training appears to be safe and effective for subacute stroke patients to improve their walking ability. Improvement in aerobic capacity, lower limb strength and ambulatory independence were observed, therefore, suggesting that Anti-gravity treadmill could be used as an alternative to improve mobility for stroke patients. Future study is needed to explore the long-term effects of the Anti-gravity treadmill training after the program completion.
