Abstract TP72: Capturing the Effects of Non-Body Weight Supported Backward and Forward Treadmill Training on Chronic Post-Stroke Lower Extremity Spasticity and Walking Speed

Abstract

Introduction: Stroke-related walking impairment significantly impacts ambulatory independence and is a major public health issue. While the factors influencing walking impairment after stroke are multifactorial, the role of lower extremity spasticity is one factor that remains unsettled. For example, while past studies have suggested that increased lower extremity tone led to maladaptive walking patterns, others have suggested that spasticity may improve walking ability by compensating for weakness. Hence, the objective of this exploratory study was to determine the effects of serial non-body weight backward (BLTT, n=19) and forward (FLTT, n=21) locomotion treadmill training on lower extremity spasticity (LES). We hypothesized that both BLTT and FLTT will improve LES, but to a greater extent with BLTT. Methods: Data from a recently completed RCT (NCT04553198) consisting of 40-community-dwelling stroke survivors with mild-moderate walking impairment, who completed nine 30-minute training sessions (3 per week x 3) were used for this secondary exploratory analysis. Spasticity was assessed (quadricep, hamstrings, gastrocnemius, soleus muscles) by a trained therapist blinded to study intervention using the modified Ashworth Scale (MAS) and 10mWT was used to assess the relationship to walking speed. Results: Training resulted in reduced spasticity in the quadriceps (p = 0.01), but not in the other three muscle groups. Contrary to our working hypothesis, FLTT drove the improvement in spasticity in both quadriceps and hamstrings (p <0.01 and p = 0.02, respectively). Both groups demonstrated improvement in walking speed (p< 0.0001), but no correlation between change MAS and walking speed was observed.