OBJECTIVE: To determine whether providing a controlled resistance versus assistance to the paretic leg at the ankle during treadmill training will improve walking function in individuals post stroke. DESIGN: Repeated assessment of the same patients with parallel design and randomized controlled study between two groups. SETTING: Research units of rehabilitation hospitals. PARTICIPANTS: Thirty patients with chronic stroke participated in this study. INTERVENTION: Subjects were stratified based on self-selected walking speed and randomly assigned to the resistance or assistance training group. For the resistance group, a controlled resistance load was applied to the paretic leg at the ankle to resist leg swing during treadmill walking. For the assistance group, a load that assists swing was applied. MAIN OUTCOME MEASURES: Primary outcome measures were walking speed and 6-minute walking distance. Secondary measures included clinical assessments of balance, muscle tone, and quality of life. Outcome measures were evaluated at pre- and post 6 weeks of training, and 8 weeks follow up, and compared within group and between the two groups. RESULTS: Following 6 weeks of robotic training, walking speed significantly increased for both groups, with no significant differences in walking speed gains observed between the two groups. In addition, six minute walking distance and balance significantly improved for assistance group but not for resistance group. CONCLUSION: Applying controlled resistance or assistance load to the paretic leg during treadmill training may induce improvements in walking speed in individuals post stroke. Resistance training was not superior to assistance training in improving locomotor function in individuals post stroke.

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