Effectiveness of Indigenous Low-Cost Manual Body Weight Supported Treadmill Training Vs Conventional Overground Gait Training in Improving Functional Ambulation & Gait Velocity in Acute Post-Stroke Hemiparetic Subjects: A Randomized Controlled Trial

Abstract

Background
Gait restoration is a central component of stroke rehabilitation. Body weight supported treadmill
training Manual (BWSTT) is a locomotor training strategy that allows early, task-specific, repetitive
practice of complete gait cycles while a harness system unloads a portion of body weight. Although
task-specific training improves gait after stroke, it remains unclear whether it produces meaningful
gains in gait velocity and functional ambulation over and above conventional overground gait training
(COGT).
Objective
To compare the effectiveness of Manual BWSTT with COGT in improving functional ambulation
and gait velocity in subjects with acute post-stroke hemiparesis.
Methods
This prospective, single-blind, randomized controlled trial enrolled 60 subjects (40 men, 20 women;
age 40–60 years) with acute hemiparesis (within 90 days of stroke onset), recruited from the outpatient
department of Physiotherapy, Hi-Tech Medical College & Hospital, Bhubaneswar. Subjects were
randomly allocated to an experimental group (Group A, n = 30), which received BWSTT (25-40%
body weight support, progressed as tolerated) in addition to a conventional rehabilitation programme,
or a control group (Group B, n = 30), which received the same conventional programme plus
overground gait training alone. Both groups trained for 20 minutes of walking practice, 4 days a week,
for 12 weeks (48 sessions). Outcomes are Functional Ambulation Category (FAC) and the 10-metre
walk test (10MWT) were assessed at baseline and after 12 weeks by a blinded assessor. Within-group
change was analysed with paired t-tests and between-group differences with independent t-tests; p ≤
0.05 was considered significant.
Results
Both groups improved significantly from baseline to 12 weeks. In Group A, mean FAC rose from 2.2
± 0.54 to 3.53 ± 0.88 (t = 37.3, p ≤ 0.05) and mean gait velocity on the 10MWT rose from 0.34 ± 0.15
m/s to 0.50 ± 0.25 m/s (t = 24, p ≤ 0.05). In Group B, mean FAC rose from 2.3 ± 0.45 to 2.63 ± 0.53
(t = 11.9, p ≤ 0.05) and mean gait velocity rose from 0.32 ± 0.12 m/s to 0.37 ± 0.12 m/s (t = 20, p ≤
0.05). The magnitude of improvement was significantly greater in Group A than in Group B for both
FAC (t = 75.18, p ≤ 0.05) and gait velocity (t = 72.22, p ≤ 0.05).
Conclusion
Twelve weeks of manual BWSTT combined with conventional therapy produced significantly greater
gains in functional ambulation and gait velocity than conventional overground gait training alone in
subjects with acute post-stroke hemiparesis.Manual BWSTT is well tolerated and represents a
practical, task-specific adjunct to standard stroke rehabilitation in a clinical setting.