Effectiveness of Anti-Gravity Treadmill Training in Improving Walking Capacity and Balance in Hemiparetic Stroke Patients: A Randomized Controlled Trial

Objective: To study the effect of anti-gravity treadmill training on walking capacity and balance in hemiparetic stroke patients. Materials and Methods: A randomized controlled trial, assessor-blinded, was conducted in sub-acute to chronic hemiparetic stroke patients with impaired gait function at Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital and Thai Red Cross Rehabilitation Center. Participants fulfilled criteria were randomly allocated by block randomization into two groups. In intervention group, ambulation training by anti-gravity treadmill was provided 30 minutes per day, five times per week for one month combined with conventional physiotherapy program. Control group received ambulation training with conventional physiotherapy program for one month. Baseline whole gait analysis, balance test, six-minute walk distance (6MWD), and functional ambulatory category (FAC) were assessed before and after treatment. Adverse events and satisfaction scale were assessed at the end of the study. Results: Thirty-one participants were randomly assigned, 15 in the intervention group and 16 in the control group. One participant from each group dropped out due to personal problems. Both, intention to treat and per protocol analysis, were done. The intervention group revealed statistically significant improvements in standing balance when measured path length from balance test via force plate (p=0.050), maximum voluntary isometric contraction (MVIC) of gluteus maximus muscle recorded by dynamic surface electromyography (p=0.004), 6MWD (p=0.001), and FAC (p=0.010). Ambulation training by anti-gravity treadmill combined with conventional physiotherapy showed a statistically significant difference of improvement in eye closed standing balance test when compared with the control group (p=0.026). Conclusion: Both groups improved in standing balance, motor power, 6MWD, and FAC in sub-acute to chronic hemiparetic stroke patients. In the present study, ambulation training by anti-gravity treadmill combined with conventional physiotherapy was superior to the control group in balance training. Keywords: Walking capacity, Balance, Anti-gravity treadmill, Stroke, FAC Received 18 Mar 2019 | Revised 8 May 2019 | Accepted 15 May 2019