| Sumario: | Background and purpose. The recovery of gait and balance is a consistent priority for individuals with stroke. Although strong evidence exists to support land-based interventions, including body weight-supported treadmill training (BWSTT), evidence to support aquatic physical therapy (AQPT) to improve gait and balance for individuals with stroke is limited. This single-subject crossover study investigated the effects of AQPT and BWSTT on the gait, balance, and quality of life of 2 people with chronic stroke. Methods. Two participants completed 2, 4-week intervention phases (AQPT, BWSTT) biweekly, with order of intervention randomized. Repeated measures, performed at each visit, included single leg stance (SLS), Romberg test (RT), and 10-meter walk test at self-selected and fast speeds. The Mini-BESTest, 6-minute walk test (6MWT), and Stroke Impact Scale (SIS) were performed before and after the study. Quasi-statistical analysis of repeated measures data was performed using the split middle lines, and comparison to minimal detectable change scores was performed for pre- and posttest data. Results. Participant 1 achieved a significant improvement in gait velocity during AQPT; Participant 2 achieved significant improvements in gait velocity during both AQPT and BWStT. Variability in SLS and RT data limited between phase comparison of these data; however, both participants improved on the Mini-BESTest after 8 weeks. The SIS score improved for Participant 2 in multiple domains related to physical functioning. On the 6MWT, Participant 2 improved after each intervention phase, while Participant 1 improved after AQPT but decreased overall after BWSTT to below baseline. Discussion and conclusions. Participant 2 experienced similar gait improvements during land-based and aquatic-based physical therapy programs, while Participant 1 experienced improvements only in response to AQPT. For individuals with chronic stroke, the aquatic environment is a supportive treatment environment therapists may consider for gait and balance training.
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