Comparative effects of overground and treadmill gait training on post-stroke quality of life and walking performance

Background: Post-stroke gait impairment significantly affects patients’ functional independence and quality of life (QoL). Gait training strategies such as overground and treadmill-based interventions are frequently employed in stroke rehabilitation, yet the comparative effectiveness of these modalities remains inconclusive. Objective: To compare the effects of overground (OGT) and treadmill (TGT) gait training on post-stroke QoL and walking performance over a 4-week intervention period comprising 12 training sessions. Methods: An experimental pre-post intervention design was employed, involving 17 stroke survivors (n = 7 over ground, n = 10 on a treadmill). Participants underwent structured gait training and were assessed using the WHOQOL-BREF, walking speed (m/s), and 6-minute walk test (6MWT) for walking capacity. A multivariate repeated measures ANOVA examined effects of time, group, and interaction on QoL domains and performance metrics. Results: Significant within-group improvement was observed in overall QoL (Wilks’ Λ = 0.501, F (1, 15) = 14.94, p =.002, partial η² = 0.499), irrespective of training modality, with no significant between-group differences (p =.712). Walking capacity demonstrated a statistically significant increase among all participants (F (1, 15) = 10.66, p =.005, partial η² = 0.415), with no significant between-group difference (p =.668). In contrast, changes in walking speed were not statistically significant (F (1, 15) = 1.96, p =.182), and no significant difference was observed between the OGT and TGT groups (p =.269). Conclusion: Both OGT and TGT significantly improved QoL and walking capacity among stroke survivors, with no superior effect observed between modalities. However, neither intervention significantly enhanced walking speed. These findings suggest that both training approaches are equally beneficial in improving endurance and overall well-being post-stroke, though additional strategies may be needed to target gait speed.