BACKGROUND:Body-weight-supported treadmill training (BWSTT) to train both fitness and ambulation has not been investigated. OBJECTIVE: To compare the effectiveness of BWSTT to dose-equivalent usual care (UC) in improving cardiovascular fitness and walking early after stroke. METHODS: Participants were randomly assigned to 1 of 2 interventions: BWSTT + UC or UC. All individuals participated in 60-minute physiotherapy sessions 5 times weekly as inpatients for 6 weeks and 3 times weekly as outpatients for another 6 weeks. Baseline, posttraining, 6-, and 12-month follow-up outcome measures were as follows: primary, fitness (peak oxygen consumption, VO2peak) and walking ability (6-Minute Walk Test [6MWT] and 10-m walk); secondary, Berg Balance Scale (BBS) and motor impairment (Chedoke-McMaster Stages of Recovery [CMSR] Leg and Foot). RESULTS: In all, 50 individuals (mean age, 60 ± 14 years; mean event-to-randomization, 23 ± 5 days; 29 men) participated. No adverse events occurred. BWSTT improved VO2peak by 30%, which was significantly greater than the 8% improvement observed for UC (P = .004 between groups). Similarly, there were significant Time × Group interactions for 6MWT and CMSR Foot, with BWSTT outperforming UC for gains in distance (P = .15; 48% vs. 19%, respectively) and stage (P = .01; 1.0 vs. 0.3, respectively). No group effect was seen for 10-m walk speed, BBS, or CMSR Leg, with both groups demonstrating significant gains. In general, gains observed were preserved for 12 months. CONCLUSIONS: BWSTT elicits greater improvements in cardiovascular fitness and walking endurance than UC in the subacute poststroke period. These gains are largely sustained for 1 year.
RCT Entities:
BACKGROUND: Body-weight-supported treadmill training (BWSTT) to train both fitness and ambulation has not been investigated. OBJECTIVE: To compare the effectiveness of BWSTT to dose-equivalent usual care (UC) in improving cardiovascular fitness and walking early after stroke. METHODS:Participants were randomly assigned to 1 of 2 interventions: BWSTT + UC or UC. All individuals participated in 60-minute physiotherapy sessions 5 times weekly as inpatients for 6 weeks and 3 times weekly as outpatients for another 6 weeks. Baseline, posttraining, 6-, and 12-month follow-up outcome measures were as follows: primary, fitness (peak oxygen consumption, VO2peak) and walking ability (6-Minute Walk Test [6MWT] and 10-m walk); secondary, Berg Balance Scale (BBS) and motor impairment (Chedoke-McMaster Stages of Recovery [CMSR] Leg and Foot). RESULTS: In all, 50 individuals (mean age, 60 ± 14 years; mean event-to-randomization, 23 ± 5 days; 29 men) participated. No adverse events occurred. BWSTT improved VO2peak by 30%, which was significantly greater than the 8% improvement observed for UC (P = .004 between groups). Similarly, there were significant Time × Group interactions for 6MWT and CMSR Foot, with BWSTT outperforming UC for gains in distance (P = .15; 48% vs. 19%, respectively) and stage (P = .01; 1.0 vs. 0.3, respectively). No group effect was seen for 10-m walk speed, BBS, or CMSR Leg, with both groups demonstrating significant gains. In general, gains observed were preserved for 12 months. CONCLUSIONS: BWSTT elicits greater improvements in cardiovascular fitness and walking endurance than UC in the subacute poststroke period. These gains are largely sustained for 1 year.
Authors: Abigail L Leddy; Mark Connolly; Carey L Holleran; Patrick W Hennessy; Jane Woodward; Ross A Arena; Elliot J Roth; T George Hornby Journal: J Neurol Phys Ther Date: 2016-10 Impact factor: 3.649
Authors: Jason-Flor V Sisante; Anna E Mattlage; Ross Arena; Michael A Rippee; Sandra A Billinger Journal: J Cardiopulm Rehabil Prev Date: 2015 Sep-Oct Impact factor: 2.081
Authors: David H Saunders; Mark Sanderson; Sara Hayes; Maeve Kilrane; Carolyn A Greig; Miriam Brazzelli; Gillian E Mead Journal: Cochrane Database Syst Rev Date: 2016-03-24
Authors: Sandra A Billinger; Jason-Flor V Sisante; Alicen A Whitaker; Michael G Abraham Journal: J Stroke Cerebrovasc Dis Date: 2017-12-01 Impact factor: 2.136