PT Critically Appraised Topics
 

Document Type

Critically Appraised Topic

Publication Date

2009

Clinical Scenario

At the inpatient rehabilitation unit I observed at, one form of body weight support system called the Lite Gait was used with certain patients post-stroke for gait training. Some therapists mainly did gait training by walking on ground without any body weight support, while other therapists preferred to use the Lite Gait over treadmill to provide partial body weight support during gait training. This led to the clinical question of whether partial body weight support over treadmill was more effective in improving gait than over ground ambulation without body weight support in patients post-stroke.

Clinical Question

Is partial body weight support over treadmill more effective than over ground ambulation without body weight support in improving gait in acute and subacute patients post-stroke?

Clinical Bottom Line

Overall, 2 of the 3 articles closely matched our clinical question, and one did not compare partial BWS over treadmill alone to overground ambulation. All 3 articles showed that both partial BWS over treadmill and overground ambulation without BWS are safe and effective gait training techniques for acute patients post-stroke. Although article 3 demonstrated a clinically important difference, the goal was to determine if an additional aerobic component made a difference in gait training, rather than if one technique was more effective than the other. It is not conclusive whether partial BWS treadmill training is more effective than over the ground gait training for walking speed and distance. Gait training with partial BWS over treadmill shows promise, but further studies with larger sample sizes and including a wider range of patients post-stroke need to be done for more conclusive results. The results of the articles did not show a clinical importance to warrant making any specific changes in gait training treatment. Therefore, the treatment technique can be determined by the available equipment and the clinician’s discretion.

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