Exercising on a Treadmill to Improve Functional Mobility in Chronic Stroke

Bodyweight-supported treadmill training for retraining gait among chronic stroke survivors: A randomized controlled study

OBJECTIVE

To evaluate the role of bodyweight-supported treadmill training (BWSTT) for chronic stroke survivors.

DESIGN

Prospective, randomized controlled study.

METHODS

Patients with a first episode of supratentorial arterial stroke of more than 3months' duration were randomly allocated to 3 groups: overground gait training, treadmill training without bodyweight support, and BWSTT (20 sessions, 30min/day, 5days/week for 4weeks). The primary outcome was overground walking speed and endurance and secondary outcome was improvement by the Scandinavian Stroke Scale (SSS) and locomotion by the Functional Ambulation Category (FAC). We analyzed data within groups (pre-training vs post-training and pre-training vs 3-month follow-up) and between groups (at post-training and 3-month follow-up).

RESULTS

We included 45 patients (36 males, mean post-stroke duration 16.51±15.14months); 40 (89.9%) completed training and 34 (75.5%) were followed up at 3months. All primary and secondary outcome measures showed significant improvement (P<0.05) in the 3 groups at the end of training, which was sustained at 3-month follow-up (other than walking endurance in group I). Outcomes were better with BWSTT but not significantly (P>0.05).

CONCLUSION

BWSTT offers improvement in gait but has no significant advantage over conventional gait-training strategies for chronic stroke survivors.

Cardiovascular stress during a contemporary stroke rehabilitation program: is the intensity adequate to induce a training effect?

OBJECTIVES

To investigate the level of cardiovascular stress of physical therapy (PT) and occupational therapy (OT) sessions of a contemporary stroke rehabilitation program and to identify therapeutic activities that elicit heart rate responses adequate to induce a training effect.

DESIGN

A descriptive, longitudinal study with heart rate and activity monitoring of PT and OT sessions at biweekly intervals, 2 to 14 weeks poststroke.

SETTING

An acute inpatient stroke unit and inpatient and outpatient stroke rehabilitation units.

PARTICIPANTS

A consecutive sample of 20 patients with ischemic stroke who participated in inpatient and outpatient stroke rehabilitation.

INTERVENTION

Observation of routine PT and OT sessions for patients poststroke without influencing the extent and content of the sessions.

MAIN OUTCOME MEASURE

Time per session in which heart rate was within the calculated target heart rate zone.

RESULTS

Time per PT session spent in target heart rate zone was low (2.8+/-0.9 min), and per OT session was negligible (0.7+/-0.2 min) over the course of rehabilitation.

CONCLUSIONS

The PT and OT sessions between 2 and 14 weeks poststroke did not elicit adequate cardiovascular stress to induce a training effect.