A pilot clinical trial on a variable automated speed and sensing treadmill (VASST) for hemiparetic gait rehabilitation in stroke patients

Abstract

Introduction Impairments in walking speed and capacity are common problems after stroke which may benefit from treadmill training. However, standard treadmills, are unable to adapt to the slower walking speeds of stroke survivors and are unable to automate training progression. This study tests a Variable Automated Speed and Sensing Treadmill (VASST) using a standard clinical protocol. VASST is a semi-automated treadmill with multiple sensors and micro controllers, including wireless control to reposition a fall-prevention harness, variable pre-programmed exercise parameters and laser beam foot sensors positioned on the belt to detect subject's foot positions. Materials and Methods An open-label study with assessor blinding was conducted in 10 community-dwelling chronic hemiplegic patients who could ambulate at least 0.1m/s. Interventions included physiotherapistsupervised training on VASST for 60 minutes 3 times per week for 4 weeks (total 12 hours). Outcome measures of gait speed, quantity, balance and adverse events were assessed at baseline, 2, 4 and 8 weeks. Results Ten subjects (8 males, mean age 55.5 years, 2.1 years post stroke) completed VASST training. Mean 10-meter walk test speed was 0.69m/s (SD 0.29) and mean 6-minute walk test distance was 178.3m (84.0). After 4 weeks of training, 70% had significant positive gains in gait speed(0.06 m/s, SD 0.08m/s, P =0.037); and 90% improved in walking distance. (54.3m, SD 30.9m, P = 0.005).. There were no adverse events. Discussion and conclusion This preliminary study demonstrates the initial feasibility and short-term efficacy of VASST for walking speed and distance for people with chronic post-stroke hemiplegia.