The study aimed to compare the effect of the treadmill walking training combined with obstacle-crossing (TWT-OC) and treadmill walking training (TWT) on the walking function of patients with chronic stroke. 29 subjects volunteered to participate in this study; they were randomly assigned to either TWT-OC group (15 subjects) or TWT group (14 subjects). Subjects from the TWT-OC group underwent a treadmill walking combined with obstacles-crossing for 30 minutes daily, three days a week for four weeks, whereas subjects from the TWT group received only a treadmill walking. The 10 m walk test (10MWT), 6-min walk test (6MWT), berg balance scale (BBS), timed up and go test (TUG), activities-specific balance confidence-Korean version (ABC-K), and walking ability questionnaire (WAQ) were measured before and after the 4-week training. The TWT-OC group showed significantly better functional mobility of walking and balance measured by 6MWT (p<.01), BBS (p<.01), and TUG scores (p<.05) when compared with those of the TWT group. Further, within-group comparison showed significant improvement in all variables (p<.01) except for 10MWT. These findings suggest that the TWT-OC and TWT may be helpful for improving the walking function of patients with chronic stroke, and the TWT-OC has probably more favorable outcomes for chronic stroke, however, further trials with wider range of subjects are warranted for generalization and clinical relevance.

This study aimed to evaluate factors related to the ability of ambulatory patients with cerebral palsy (CP) to walk over vertical and horizontal obstacles. Twenty patients with spastic CP who were able to walk independently for at least 10 m with or without walking devices were recruited for the study. Participants were required to walk over small obstacles (1, 4, and 8 cm in height or width; total of 6 conditions). A 'fail' was recorded when either the lower limbs or the walking device contacted the obstacle. Linear regression analyses were used to determine the effects of age, sex, walking devices, eyeglasses, subtype (hemiplegia or diplegia), ankle foot orthoses, functional level, and score of body mass index on the ability of obstacle crossing. Fifteen participants (75%) failed to adequately clear the foot or walking device over obstacles in at least 1 condition. The chance of failure in crossing vertical obstacle was affected by the use of ankle foot orthoses, eyeglasses, gender, and CP subtype (p<.05). The failure rate crossing horizontal obstacle was affected by CP subtype. These findings suggest that rehabilitation procedures should (1) consider the clinical characteristics of patients in order to prepare them to be more independent while performing daily activities, and (2) incorporate environmental conditions that patients encounter at home and in the community.