Effect of Underwater Gait Training with a Progressive Increase in Speed on Balance, Gait, and Endurance in Stroke Patients

Abstract

This study aimed to investigate the effect of progressive speed increase during underwater gait training on stroke patients' balance, gait, and endurance, as well as to compare the effects of underwater gait training and land gait training. Methods: Subjects were randomly allocated into three groups. Underwater gait training group (n= 10), land gait training group (n= 9) and control group (n= 9). The groups performed their respective programs as well as conventional physical therapy 3 times/week for 8 weeks. The patients were assessed before and after the experiment in terms of the Berg balance scale, characteristics of gait, and 6-minute walking test. Results: The beneficial effect perceived in the speed increase underwater gait training (UGT) group was significantly greater than in the groups who were trained with speed increase land gait training (LGT) group, and the control group regarding the following aspects: the Berg balance scale, the affected step length, the affected stride length, and the 6-minute walking test (p< 0.05). The LGT group showed a more significant effect on the Berg balance scale, the affected step length, the affected stride length, and the 6-minute walking test (p < 0.05), compared to the control group. Furthermore, the UGT group showed a significantly greater effect on the gait speed when compared to the control groupb (p< 0.05). Conclusion: This study shows that progressive UGT is effective in improving balance, gait, and endurance in stroke patients. Therefore, we believe that progressive UGT may be used as a method for general physical therapy in patients with stroke.

The Effect of Water-Based Therapy Compared to Land-Based Therapy on Balance and Gait Parameters of Patients with Stroke: A Systematic Review

“…Saharan et al [17] stated that they were unable to determine which group improved more than the other. Distance traveled by patients through walking was improved significantly in both groups, but the improvement was greater in the water-based therapy group [15,18,22,27]. The time that patients require to cross a specific distance through walking was improved in the water-based therapy group, and there was no significant difference in the land-based therapy group [14,24].…”

“…The study by Douris et al [21] is the only study that examined older adults instead of stroke patients; however, it included all the other research question components. Both water-based therapy and land-based therapy improved the participants' scores in BBS [14,15,[18][19][20][21][22][23][24]. A higher improvement was seen in the water-based therapy group compared to the landbased therapy group [14,18,20,22,24].…”

“…Both water-based therapy and land-based therapy improved the participants' scores in BBS [14,15,[18][19][20][21][22][23][24]. A higher improvement was seen in the water-based therapy group compared to the landbased therapy group [14,18,20,22,24]. Three studies stated that there is no significant difference between the 2 groups in the scores of BBS [15,23,24].…”

Aerobic Exercise After Left-Sided Stroke Improves Gait Speed and Endurance

“…Treadmill walking is a highly specific task for gait because it increases the number of steps that individuals walk in their daily lives 31 . This station in our protocol helps us understand the increase in gait endurance seen in our participants.…”

A study on locomotion characteristics according to the level of cardiorespiratory endurance in adolescents

“…The locomotion characteristics test consisted of one minute of walking at a slow (3.2 km/h), normal (4 km/h), and fast speed (4.8 km/h). The decision was made by adjusting the previous/next speed by about 20% based on the protocol of Kim et al 31 , with a locomotion capacity of 4 km/h as an average speed. The 20-m shuttle run recorded the best performance (until they feel they can't run anymore) with one measurement.…”