OBJECTIVE: To compare body weight-supported exercise on a gait trainer with walking exercise overground. DESIGN: Randomized controlled trial. SETTING: Rehabilitation hospital. PARTICIPANTS: Forty-five ambulatory patients with chronic stroke. INTERVENTIONS: Patients were randomized to 3 groups: (1) gait trainer exercise with functional electric stimulation (GTstim), (2) gait trainer exercise without stimulation (GT), and (3) walking overground (WALK). All patients practiced gait for 15 sessions during 3 weeks (each session, 20 min), and they received additional physiotherapy 55 minutes daily. MAIN OUTCOME MEASURES: Ten-meter walk test (10MWT), six-minute walk test (6MWT), lower-limb spasticity and muscle force, postural sway tests, Modified Motor Assessment Scale (MMAS), and FIM instrument scores were recorded before, during, and after the rehabilitation and at 6 months follow-up. RESULTS: The mean walking distance using the gait trainer was 6,900 +/- 1,200 m in the GTstim group and 6,500 +/- 1,700 m in GT group. In the WALK group, the distance was 4,800 +/- 2,800 m, which was less than the walking distance obtained in the GTstim group (p = 0.027). The body-weight support was individually reduced from 30% to 9% of the body weight over the course of the program. In the pooled 45 patients, the 10MWT (p < 0.001), 6MWT (p < 0.001), MMAS (p < 0.001), dynamic balance test time (p < 0.001), and test trip (p = 0.005) scores improved; however, no differences were found between the groups. CONCLUSIONS: Both the body weight-supported training and walking exercise training programs resulted in faster gait after the intensive rehabilitation program. Patients' motor performance remained improved at the follow-up.

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