Saint Louis University

School of Nursing

A JOURNAL ENTITLED:

“The Efficacy of Gait Training Using a

Body Weight Support Treadmill and
Visual Biofeedback in Patients with
Subacute Stroke: A Randomized
Controlled Trial “
By:

Mariusz Druhbicki , Grzegorz Przysada, Agnieszka Guzik , Agnieszka

Brzozowska-MagoN , Krzysztof KoBodziej, Andzelina Wolan-Nieroda, Joanna
Majewska , and Andrzej Kwolek

SUBMITTED BY:
ARIANNE JOY SALVADOR

SUBMITTED TO:
SIR JUNEL BRYAN BAJET
 AUGUST 2018

SUMMARY:
-This study was designed to determine whether or not gait training based on the use of treadmill
with visual biofeedback and body weight support (BWS) would produce better effects in patients
with sub-acute stroke compared to BWS treadmill training with no visual biofeedback. 30
patients with sub-acute stroke were randomly assigned to do body weight supported treadmill
training with visual biofeedback (BB group) or BWS treadmill training without visual
biofeedback. Their gait was assessed with a 3D system (spatiotemporal gait parameters and
symmetry index) and by means of 2-minute walk test (2 MWT), 10-metre walk test (10 MWT),
and Timed Up & Go test. Subjects in both groups participated in 15 treadmill training sessions
(30 minutes each). The participants from both groups achieved a statistically significant
improvement in spatiotemporal gait parameters, walking speed, endurance, and mobility. The
average change in the BB group after the end of the programme did not differ significantly
compared to the change in the control group. The change in the symmetry index value of stance
phase in the BB group was 0.03 (0.02) and in the control group was 0.02 (0.02). The difference
was not statistically significant (ρ = 0.902). The statistically significantly higher improvement in
the BB group was found in the range of walking speed (ρ = 0.003) and endurance (ρ = 0.012),
but the difference between groups was of low clinical significance. The findings do not confirm
that BWS treadmill training with the function of visual biofeedback leads to significantly greater
improvement in gait compared to BWS treadmill training with no visual biofeedback at an early
stage after stroke.
 Insights/Relevance to pt’s case/care
 My patient is considered as neurologically impaired individual, which
walking dysfunction arising from the impairments associated with
secondary cardiovascular and musculoskeletal consequences of disuse and
physical inactivity. Muscle weakness and paralysis, poor motor control and
soft tissue contracture are major contributors to walking dysfunction after
stroke which is manifested in my patient. Concluded that there was evidence
that treadmill training with or without BWSTT resulted in improvements in
gait performance, I can share this result to my patient and would collaborate
to her physical therapist if this can be apply to her as one of her training
sessions.

 Relevance to area of rotation/local setting/Philippines

 According to the journal The Real Stroke Burden in the Philippines by Navarro
stroke is the Philippines' second leading cause of death. It has a prevalence of
0·9%; ischemic stroke comprises 70% while hemorrhagic stroke comprises 30%.
Since stroke is prevalent in our country and there are post stroke patients that we
 may be handling in the area, we can discuss the findings of this journal to enhance
the interventions to our post stroke patients that will help them to achieve the
optimal functioning in their daily lives.

 Relevance to Nursing Education, Practice, Research

 In Nursing education, as student nurses we must be updated on what are the new
intervention that can help with the care of our patients, so that we can also add
some knowledge regarding to what interventions is fit to their illnesses. This
study can be shared in classes, groups, or other nursing students to widen their
knowledge regarding to interventions in a post stroke patient and the benefit of
the intervention to the patient.

 In Nursing practice, if the patient can tolerate this activity we can collaborate to
the medical team especially to the physical therapist of your patient regarding to
the implementation of this intervention in order to improve the gait pattern and
strengthens the musculoskeletal of the patient.

 In Nursing research, studies like this can help health care workers as well as
others to widens their knowledge and be updated to the interventions that might
help in the health care setting. Also, this research can be a reference as well to the
future studies.

 Learning insights on the journal

 I learned that gait reeducation after stroke with the use of treadmill and BWS
systems leads to an increase in gait speed and walking distance. This journal is
helpful in adding knowledge about stroke patients, the effect of gait training
sessions to the improvement of functional status of the patient and prevent
permanent disability.

REFERNCES:
 Druhbicki, M., Przysada, G., Guzik, A., Brzozowska-MagoN, A., KoBodziej, K., Wolan-
Nieroda, A., . . . Kwolek, A. (2018). The Efficacy of Gait Training Using a Body Weight
Support Treadmill and Visual Biofeedback in Patients with Subacute Stroke: A
Randomized Controlled Trial. The Efficacy of Gait Training Using a Body Weight Support
Treadmill and Visual Biofeedback in Patients with Subacute Stroke: A Randomized
Controlled Trial,1-12. doi:doi.org/10.1155/2018/3812602
 Drużbicki, M., PhD, Guzik, A., PhD, Przysada, G., MD, Kwolek, A., MD, & Brzozowska-
Magoń, A. (2015). EFFICACY OF GAIT TRAINING USING A TREADMILL WITH AND
WITHOUT VISUAL BIOFEEDBACK IN PATIENTS AFTER STROKE: A RANDOMIZED
STUDY. EFFICACY OF GAIT TRAINING USING A TREADMILL WITH AND WITHOUT VISUAL
BIOFEEDBACK IN PATIENTS AFTER STROKE: A RANDOMIZED STUDY,1-7.
doi:10.2340/16501977-1949