Immediate Effects of Walker-Assisted Gait Training at Higher Training Speeds Comparing Conditions With and Without
Hiroo Koshisaki1, Shota Nagai2
1Department of Rehabilitation, Nanto Municipal Hospital, Nanto, JPN.
Background:
Body weight-supported treadmill training (BWSTT) permits patients with stroke to practice walking at higher speeds under safe conditions but is limited by cost and accessibility. A suspended body weight-supported (BWS) walker has been developed as a practical alternative, enabling higher training speeds during walker-assisted gait training. However, it is unclear whether high-speed BWS walker-assisted gait training leads to immediate improvements in gait performance and how training speed and body weight support contribute to these effects.
Methods:
Twenty patients with chronic stroke participated in a crossover study. Each participant underwent two gait training sessions using the same walker device: one without BWS and one with BWS activated. Gait performance was assessed before and after each session using the 10 m walk test. Training speed during each session was recorded to evaluate its relationship with pre-to-post changes in gait performance.
Results:
Training with BWS enabled higher training speeds and resulted in significant improvements in gait speed and affected side step time, with a significantly greater increase in gait speed than that during training without BWS. Of the participants, 70% demonstrated increased training speed accompanied by immediate improvements in gait speed during BWS walker-assisted training. Improvements in gait speed were associated with increased stride length and reduced affected side step time.
Conclusion:
Walker-assisted gait training that enables higher training speeds, particularly when combined with BWS, may contribute to immediate improvements in gait speed in patients with stroke. Reductions in affected side step time may represent one mechanism underlying this training speed-related effect.
