Kinematic Analysis of Land and Aquatic Treadmill Walking in Individuals with Stroke: 10:30AM-10:45AM: 588

Partial weight bearing (PWB) treadmill-based gait training has shown to be effective in gait rehabilitation of people with stroke. The PWB effect can be achieved by using aquatic treadmill.

PURPOSE: The purpose of this study was to analyze biomechanical gait variables of conventional treadmill and aquatic treadmill walking in individuals with stroke. The findings will help clinicians have better understanding of aquatic treadmill-based gait training for people with stroke.

METHODS: A multivariate repeated measure study was used to compare biomechanical differences between land and aquatic treadmill walking. Nine individuals with stroke (M=7, F=2; age range 50-76 yrs, mean 55) participated in the study. A two dimensional video-based motion analysis system (E-Human software, HMA Tech., Ontario, Canada) was used to capture and analyze all walking trials. Underwater digital motion capturing system (Equinox, Galesburg, MI) and aquatic treadmill (AquaGaiter, FERNO, Willington, OH) were used. A total of 12 water-proof markers were attached on both legs for image digitization. Initially all participants were given five-minute familiarization trials on both treadmills. They were asked to select their comfortable walking speeds during the familiarization trial on land treadmill. The selected speed was applied to both walking conditions. Three two-minute testing trials were captured for each treadmill walking.

RESULTS: The results showed that there were significant differences in spatiotemporal and kinematic variables. The stride time and stride length of both paretic and non-paretic limbs were significantly greater during aquatic treadmill walking (all Ps < .05). However, the cadence of both limbs was significantly lower during aquatic treadmill walking at a matched speed as compared to land treadmill walking (all Ps < .05). No significant differences were noted in the hip joint of both limbs. While the paretic limb did not show any significant difference in the knee joint, non-paretic limb showed less peak knee flexion angle and greater peak knee extension angle during aquatic treadmill walking (all Ps< .05). The peak ankle dorsiflexion was less and the peak ankle plantarflexion was greater on both limbs during aquatic treadmill walking (all Ps< .05).

CONCLUSIONS: The study results indicate that aquatic treadmill-based gait training can be used to improve stride length of people with stroke. However, the increased plantarflexion during aquatic treadmill walking should be considered when providing aquatic gait training for individuals with ankle deformities.