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Effects of exercise training programs on walking competency after stroke: a systematic review.
Ingrid G L van de Port1, Sharon Wood-Dauphinee, Eline Lindeman
1Center of Excellence for Rehabilitation Medicine Utrecht, Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands.
American Journal of Physical Medicine & Rehabilitation
|February 17, 2007
Summary
Gait-oriented training significantly improves walking speed and distance in stroke survivors. While cardiorespiratory training aids stair climbing, lower-limb strengthening shows no significant benefits for gait post-stroke.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Physical Therapy
Background:
- Stroke frequently impairs gait, affecting mobility and quality of life.
- Effective rehabilitation strategies are crucial for post-stroke recovery.
- Gait-oriented training, lower-limb strengthening, and cardiorespiratory fitness programs are common interventions.
Purpose of the Study:
- To evaluate the effectiveness of different training programs on gait, related activities, and quality of life after stroke.
- To synthesize evidence from randomized controlled trials (RCTs) on post-stroke rehabilitation.
Main Methods:
- Systematic search of multiple databases for RCTs up to November 2005.
- Inclusion criteria: stroke participants, gait-related outcomes, specific training types, English/German/Dutch publications.
- Methodological quality assessed using the PEDro scale; meta-analysis and best-evidence synthesis applied.
Main Results:
- Gait-oriented training showed significant medium effects on gait speed and walking distance.
- Cardiorespiratory fitness programs had a nonsignificant medium effect on gait speed.
- No significant effects were found for lower-limb strengthening programs; strong evidence supported cardiorespiratory training for stair climbing.
Conclusions:
- Gait-oriented training is effective for improving walking competency after stroke.
- Cardiorespiratory training shows promise for specific functional improvements like stair climbing.
- Further research may be needed to enhance effects on daily living activities and quality of life.
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