Related Experiment Video
Updated: May 10, 2026
A Rehabilitation Program of Exoskeleton-assisted Body Weight-Supported Treadmill Training with Non-immersive Virtual Reality for Stroke Patients
Published on: May 16, 2025
Does altering inclination alter effectiveness of treadmill training for gait impairment after stroke? A randomized
Stefano Carda1, Marco Invernizzi, Alessio Baricich
1Department of Neuropsychology and Neurorehabilitation, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. stefano.carda@chuv.ch
Objective:
To assess whether a downhill walking training programme is more effective than the same amount of training applied uphill in chronic stroke survivors.
Design:
Randomized, single-blind study.
Setting:
Outpatient rehabilitation service.
Methods:
Thirty-eight adults with hemiplegia from stroke lasting more than three months were randomly allocated to one of the two groups: 'UP' - 45 minutes of physical therapy + 30 minutes of treadmill with 5% ascending slope; and 'DOWN' - 45 minutes of physical therapy + 30 minutes of treadmill with 5% descending slope. Both groups were treated 5 times a week for six weeks. Patients were evaluated before treatment, at the end of treatment and after three months.
Outcome Measures:
Primary outcome measure was the number of patients showing an improvement in 6-minute walking test (6MWT) greater than 50 m. Secondary outcome measures were: (1) number of patients showing a clinically relevant improvement of gait speed during 10-m walking test (10mWT); (2) number of patients showing an improvement in timed up and go (TUG) greater than minimal detectable change.
Results:
Both groups had a significant improvement after treatment and at follow-up. At the end of treatment, compared to UP group, more patients in the DOWN group showed clinically significant improvements in primary and secondary outcomes (16/19 patients for 6MWT, 11/19 patients for 10mWT and 9/19 patients for TUG compared with 3/19, 4/19 and 2/19 patients, respectively, P < 0.01). At follow-up, results were similar except for 10mWT.
Conclusions:
In chronic stroke patients, downhill treadmill training produces a bigger effect than uphill training.
