Bodyweight Supported Treadmill Vs. Overground Walking Effects On Gait And Quality Of Life In Multiple Sclerosis: A Proof Of Concept Study

Abstract

Multiple Sclerosis (MS) often leads to difficulties with walking, balance, and daily mobility. Rehabilitation programs that reduce fall risk while promoting active walking may be important for maintaining function. Bodyweight supported (BWS) treadmill training is frequently used in rehabilitation, yet BWS overground walking, which more closely resembles real-world mobility, has received far less study. The purpose of this thesis was to examine the feasibility of an eight-week BWS overground training intervention in people with MS and to compare its effects with BWS treadmill training on functional mobility, gait, and self-reported outcomes.

This proof-of-concept study used a crossover design in which five adults with MS completed sixteen sessions of both BWS overground and treadmill training. Attendance and missed-session reasons were recorded, and participants completed balance confidence and quality-of-life questionnaires, as well as timed functional mobility tests and free-living activity monitoring during each intervention phase.

Participants attended most training sessions, and no statistically significant difference in attendance was observed between interventions, demonstrating that BWS overground training was feasible for individuals with MS. Across both interventions, changes in functional mobility, gait metrics, and self-reported outcomes were generally small, and no statistically significant differences were detected between the treadmill and overground conditions. Effect sizes suggested mostly negligible to moderate improvements, depending on the measure. Exploratory analyses considered participant preference and suggested that individuals tended to perform better on the modality they preferred, indicating that personal comfort or perceived suitability may influence response to training.

Overall, this study provides initial evidence that BWS overground training is feasible and produces functional outcomes comparable to BWS treadmill training. These findings support continued investigation into overground BWS training and highlight the potential value of individualized rehabilitation approaches. Future research should explore how training progression, patient preference, and specific exercise strategies can optimize mobility and quality-of-life outcomes in people living with MS.