Abstract
Objective: The purpose of this study was to determine the effects of underwater treadmill gait training with water-jet resistance and underwater treadmill gait training with ankle weights on balance and gait abilities in chronic stroke patients.Methods: Twenty-two inpatients and outpatients with stroke-induced impairments were randomly assigned into two groups: an underwater treadmill gait training with water-jet resistance group (n = 11) and an underwater treadmill gait training with ankle weights group (n = 11). Participants received conventional physical therapy for 30 min and underwater treadmill gait training with water-jet resistance or ankle weights for 30 min. Intervention was performed 5 days a week for 4 weeks. The Balance System SD was used to assess static and dynamic balance. The GAITRite system was used to assess gait velocity, cadence, step length, stride length, and swing phase. All measurements were performed at the beginning of the study and 4 weeks after the intervention.Results: The water-jet resistance group and ankle weights group showed significant improvement in static balance (P < 0.00 vs. P = 0.01), dynamic balance (P < 0.00 vs. P = 0.57), gait velocity (P < 0.00 vs. P = 0.037), cadence (P < 0.00 vs. P = 0.001), step length (P < 0.00 vs. P = 0.003), stride length (P < 0.00 vs. P = 0.023), and swing phase (P < 0.00 vs. P < 0.00). However, the static and dynamic balance ability score (P < 0.00), gait velocity (P < 0.00), cadence (P < 0.00), step length (P < 0.00), stride length (P < 0.00), and swing phase (P = 0.023) in the group that received underwater treadmill gait training with water-jet resistance improved more than in the group that received underwater treadmill gait training with ankle weights.Conclusions: Our results demonstrated that underwater treadmill gait training with water-jet resistance is effective in improving static and dynamic balance as well as gait abilities in chronic stroke patients. Thus, training using underwater treadmill gait training with water-jet resistance may be useful in facilitating active rehabilitation in chronic stroke patients.
Highlights
Stroke patients have impaired walking ability due to decreased balance and are prone to falls [1, 2]
The initial speed of this program based on the study that treadmill training performed at the fastest speed that stroke patients can perform was significantly increased in stride length, walking speed, and step length than that of fixed speed treadmill training
Between Jun 2017 and Dec 2017, a total of 30 patients were admitted to the rehabilitation center, 22 fulfilled the inclusion criteria
Summary
Stroke patients have impaired walking ability due to decreased balance and are prone to falls [1, 2]. Weight-bearing treadmill training using a task-oriented approach is designed to improve balance and gait ability in hemiplegic patients [7,8,9]. To provide treadmill training for stroke patients, it is necessary to promote a sense of stability. Underwater treadmill training by using the buoyancy can be promoted to gait disturbance of stroke patients rather than land-based treadmill training because of effectively reducing body weight. Underwater treadmill training reduces the burden on weight-bearing joints and the risk of falling, and provides resistance during movement in multiple directions [13]. Underwater aerobic exercise that reproduces the action of walking and running is increasingly popular [14]
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