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Treadmill training to improve mobility for people with sub-acute stroke

This phase II study investigated the feasibility and potential
effectiveness of treadmill training versus normal gait re-education for ambulant
and non-ambulant people with sub-acute stroke delivered as part of normal
clinical practice. DESIGN:
A single-blind, feasibility randomized controlled
trial. SETTING: Four hospital-based stroke units.
SUBJECTS: Participants within
three months of stroke onset. INTERVENTIONS: Participants were randomized to
treadmill training (minimum twice weekly) plus normal gait re-education or normal
gait re-education only (control) for up to eight weeks. MAIN MEASURES: Measures
were taken at baseline, after eight weeks of intervention and at six-month
follow-up. The primary outcome was the Rivermead Mobility Index. Other measures
included the Functional Ambulation Category, 10-metre walk, 6-minute walk,
Barthel Index, Motor Assessment Scale, Stroke Impact Scale and a measure of
confidence in walking.
RESULTS: In all, 77 patients were randomized, 39 to
treadmill and 38 to control. It was feasible to deliver treadmill training to
people with sub-acute stroke. Only two adverse events occurred. No statistically
significant differences were found between groups. For example, Rivermead
Mobility Index, median (interquartile range (IQR)): after eight weeks treadmill 5
(4-9), control 6 (4-11) p = 0.33; or six-month follow-up treadmill 8.5 (3-12),
control 8 (6-12.5) p = 0.42.
The frequency and intensity of intervention was low.
CONCLUSION: Treadmill training in sub-acute stroke patients was feasible but
showed no significant difference in outcomes when compared to normal gait
re-education. A large definitive randomized trial is now required to explore treadmill training in normal clinical practice.

Langue : ANGLAIS

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