Balance, Balance Confidence, and Health-Related Quality of Life in Persons With Chronic Stroke After Body Weight-Supported Treadmill Training

Combs SA, Dugan EL, Passmore M, Riesner C, Whipker D, Yingling E, Curtis AB. Balance, balance confidence, and health-related quality of life in persons with chronic stroke after body weight-supported treadmill training. Arch Phys Med Rehabil 2010;91:1914-9. Objectives: To examine changes in balance, balance confidence, and health-related quality of life immediately and 6 months after body weight-supported treadmill training (BWSTT) for persons with chronic stroke (primary objective) and to determine whether changes in gait speed after BWSTT were associated with changes in these dimensions of health (secondary objective). Design: Prospective pre-/posttest pilot study with 6 months retention. Setting: University research laboratory settings. Participants: A convenience sample of participants (N=19; at least 6mo poststroke; able to ambulate 0.4-0.8m/s) were recruited. Intervention: BWSTT was provided for 24 sessions over 8 weeks with 20 minutes of total walking each session. Main Outcome Measures: Berg Balance Scale (BBS), Activities-Specific Balance Confidence (ABC) Scale, Stroke Impact Scale (SIS), comfortable 10-m walk test (CWT), and fast 10-m walk test (FWT). Proportions of participants who achieved minimal detectable changes (MDCs) were examined for all measures. Results: Statistically significant improvements were found from pre- to posttest for BBS, ABC, SIS mobility, SIS stroke recovery, and CWT scores (P<.05) and from pretest to retention on BBS, ABC, CWT, and FWT scores (P<.05). For most participants, improvements did not exceed MDCs. Changes in gait speed and BBS, ABC, and SIS scores were not associated. Conclusions: The findings of this study suggest that effects of BWSTT may transfer beyond gait to positively influence balance, balance confidence, and health-related quality of life. However, for most participants, BWSTT was not sufficient to induce improvements in balance and balance confidence beyond measurement error or long-term retention of enhanced perceptions of quality of life.