Dissertation Defenses

Doctoral Dissertation Announcement

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Candidate: Stephanie A. Combs

Degree of: Doctor of Philosophy

Department: Interdisciplinary Health Sciences

Title: Effects of Body Weight Supported Treadmill Training on Motor Performance, Task Accomplishment and Participation in Persons with Chronic Stroke

Committee:
Dr. Amy Curtis, Chair
Dr. Eric Dugan
Dr. Ellen W. Miller
Dr. Michael Stoline

Date: Friday, October 16, 2009 12:00 p.m. - 2:00 p.m.
2073 College of Health and Human Services

Abstract:
Although previous evidence surrounding body weight supported treadmill training (BWSTT) for persons with chronic stroke clearly indicates its effectiveness for increasing gait velocity, it is not apparent whether the intervention affects other dimensions of health. The purpose of this dissertation is to use an interdisciplinary approach to investigate the effects of BWSTT on motor performance, task accomplishment and participation in persons with chronic stroke. A convenience sample of 19 participants at least 6 months post-stroke, who are able to ambulate between 0.4 – 0.8 m/s and 22 participants without disability, were recruited for this prospective study. Participants with stroke completed 24 sessions of BWSTT over 8 weeks with 20 minutes of total walking each session. Both groups underwent testing with bilateral 3D motion analysis. Additionally, the stroke group was assessed with the comfortable 10-meter walk test (CWT), the Berg balance scale (BBS), the activities-specific balance confidence scale (ABC) and the stroke impact scale (SIS). Measures are conducted 1-week before (pre-test) and after (post-test) BWSTT and 6-months after BWSTT (retention). Concurrent with a statistically significant increase in the CWT from pre- to post-test (p=.001) and from pre-test to retention (p=.008), intralimb and interlimb coordination significantly improves from pre- to post-test and pre-test to retention (p<.05). The greatest percentage of significant changes in coordination across the gait cycle occurs within the distal segments of the paretic leg and during swing phase. No statistically significant differences in relative propulsion in the paretic leg or relative positive joint work at the hip, knee or ankle in the paretic and non-paretic legs are found over time (p>.05). Statistically significant improvements on the BBS (p=.007), ABC (p=.000), SIS mobility (p=.023) and SIS stroke recovery (p=.001) are found from pre- to post-test. Significant improvements are maintained at retention on the BBS (p=.000) and ABC (p=.038). These findings reveal that the benefits of BWSTT expand beyond gait velocity and indicate its application as an adjunct intervention to facilitate transfer to other dimensions of health. Future studies on persons with chronic stroke are needed to investigate different BWSTT progression protocols and to compare the effects of BWSTT to other interventions.