Efficacy of Harness-Supported Treadmill Training Without Body-Weight Unloading on Balance and Mobility After Stroke

Background: Gait impairment is one of the most debilitating consequences of stroke, often restricting mobility, independence, and community reintegration. Treadmill-based gait training enhances neuroplasticity through repetitive, task-specific practice. However, body-weight-support systems are costly and not always available in routine rehabilitation. This study investigated the efficacy of harness-supported treadmill gait training without body-weight unloading compared with conventional overground therapy in individuals with post-stroke hemiplegia. Methods: Thirty adults (aged 40–60 years) with first-ever unilateral middle cerebral artery stroke and mild-to-moderate hemiparesis (Orpington Prognostic Score < 5.2) were randomly allocated to two groups: (1) conventional Bobath-based overground gait training, or (2) treadmill gait training with overhead harness support (no unloading). Both interventions were administered for 20 minutes, three times per week, over six weeks. The Stroke Rehabilitation Assessment of Movement (STREAM), Berg Balance Scale (BBS), and 10-Meter Walk Test (10MWT) served as primary outcome measures. Data were analyzed using independent t-tests, and effect sizes (Cohen’s d) were calculated. Results: Both groups showed significant within-group improvements (p < .01), but the treadmill group demonstrated superior gains in motor recovery and balance: STREAM (+6.20 ± 2.18 vs. +3.73 ± 2.16; p = .005; d = 1.17), BBS (+8.00 ± 4.19 vs. +4.20 ± 2.81; p = .025; d = 0.98), and gait velocity (+0.126 ± 0.035 m/s vs. +0.097 ± 0.025 m/s; p = .025; d = 0.90). All participants completed the program without adverse events, confirming excellent safety and adherence. Conclusion: Harness-supported treadmill gait training without body-weight support significantly enhances balance and mobility in post-stroke hemiplegia. The approach offers neuroplasticity-driven functional gains comparable to more sophisticated body-weight-supported or robotic systems, while remaining low-cost, safe, and easily implementable in routine clinical practice.