Date of Award

5-2022

Degree Type

DPT Project

Degree Name

Doctor of Physical Therapy (DPT)

Advisor

Balachandar Kathirvelu

Abstract

Background. Optimizing rehabilitation techniques for patients with chronic stroke remains an ongoing effort. Previous research has yet to synthesize the effectiveness of underwater treadmill training (UTT) and body weight supported treadmill training (BWSTT) for improving common impairments in balance and gait.

Purpose. The purpose of this review was to compare the effectiveness of UTT in helping to normalize reciprocal gait pattern and improve balance compared to BWSTT in patients with chronic cerebrovascular accidents (CVA).

Data Sources. CINAHL, Medline, PubMed, and Embase databases were searched over a period of several months from October of 2020 through March of 2021.

Study Selection. Four individuals screened peer reviewed randomized controlled trials that assessed adults 18 years and older who had received a CVA diagnosis within the past 12 months. Studies with balance and gait related outcomes combined with aquatic therapy or body weight supported treadmill training interventions were included. Six studies met inclusion criteria.

Data Extraction. Four individuals screened abstracts and extracted data on participant demographics and physical therapy interventions. The Critical Appraisal Skill Programme (CASP) was used to evaluate study quality and assess risk of bias.

Data Synthesis. Subjects undergoing UTT improved significantly in aspects of balance and gait compared to the control groups. Studies investigating BWSTT demonstrated similar statistically significant improvements in DGI scores and temporal characteristics of gait among the experimental and control groups.

Limitations. The studies included were of fair to good quality but had high levels of heterogeneity in outcome measures, intervention protocols, and methodology, making direct comparisons of results challenging for this systematic review.

Conclusion. This systematic review found that UTT is superior to conventional therapy for improving balance and gait characteristics while BWSTT is as effective as conventional therapy. Clinicians may consider using UTT or BWSTT to improve patient outcomes if appropriate equipment is available. Further research is needed to investigate direct comparisons between UTT and BWSTT to determine if current evidence is accurate on using these interventions to normalize reciprocal gait patterns and improve balance for patients with chronic stroke.

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