Title

Effects of Body Weight Supported Treadmill Training on Motor Performance, Task Accomplishment and Participation in Persons with Chronic Stroke

Date of Award

12-2009

Degree Name

Doctor of Philosophy

Department

Interdisciplinary Health Sciences

First Advisor

Dr. Amy Curtis

Second Advisor

Dr. Eric Dugan

Third Advisor

Dr. Ellen W. Miller

Fourth Advisor

Dr. Michael Stoline

Abstract

Although previous evidence surrounding body weight supported treadmill training (BWSTT) for persons with chronic stroke indicates its effectiveness for increasing gait velocity, it is not apparent whether BWSTT affects other dimensions of health. The purpose of this dissertation was to use an interdisciplinary approach to investigate the effects of BWSTT on motor performance, task accomplishment and participation in persons with chronic stroke. A convenience sample of 19 participants at least 6 months post-stroke who were able to ambulate between 0.4–0.8 m/s and 22 participants without disability were recruited for this prospective study. Participants with stroke completed 24 sessions of BWSTT over 8 weeks. Both groups underwent testing with 3D motion analysis. Additionally, the stroke group was assessed with the comfortable 10-meter walk test (CWT), the Berg balance scale (BBS), the activities-specific balance confidence scale (ABC) and the stroke impact scale (SIS). Measures were conducted 1 week before (pre-test) and after (post-test) BWSTT and 6 months after BWSTT (retention). Concurrent with a statistically significant increase in the CWT from pre- to post-test (p = .001) and from pre-test to retention (p = .008), intralimb and interlimb coordination significantly improved from pre- to post-test and pre-test to retention (p < .05). The greatest percentage of significant changes in coordination across the gait cycle occurred within the distal segments of the paretic leg and during swing phase. No statistically significant differences in relative propulsion in the paretic leg or relative positive joint work at the paretic or non-paretic hip, knee or ankle were found over time ( p > .05). Statistically significant improvements on the BBS ( p = .007), ABC (p = .000), SIS mobility ( p = .023) and SIS stroke recovery (p = .001) were found from pre- to post-test. Significant improvements were maintained at retention on the BBS (p = .000) and ABC (p = .038). These findings reveal that the benefits of BWSTT expand beyond gait velocity and indicate its application as an adjunct intervention to facilitate transfer to other dimensions of health. Future studies are needed to investigate different BWSTT protocols and to compare its effects to other interventions.

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