Treadmill training and body weight support for walking after stroke.
Jan Mehrholz1, Marcus Pohl, Bernhard Elsner
1Wissenschaftliches Institut, Private Europäische Medizinische Akademie der Klinik Bavaria in Kreischa GmbH, An der Wolfsschlucht 1-2, Kreischa, Germany, 01731.
The Cochrane Database of Systematic Reviews
|January 25, 2014
Summary
Treadmill training with body weight support (BWsim) does not improve independent walking post-stroke but enhances walking speed and endurance. Ambulatory patients experience lasting benefits in endurance, with no increased adverse events.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Physical Therapy
Background:
- Treadmill training, with or without body weight support (BWsim), is a common rehabilitation technique aimed at improving walking ability in individuals who have experienced a stroke.
- This review is an update of previous research, first published in 2005, to incorporate the latest evidence on this intervention.
Purpose of the Study:
- To evaluate the effectiveness of treadmill training with and without BWsim in improving walking ability, quality of life, and daily living activities in stroke survivors.
- To assess the safety and acceptability of treadmill training as a physiotherapy gait intervention post-stroke.
Main Methods:
- A systematic review and meta-analysis of randomized or quasi-randomized controlled and cross-over trials.
- Searched multiple databases including Cochrane, MEDLINE, EMBASE, CINAHL, AMED, and SPORTDiscus up to July 2013.
- Two authors independently selected trials, extracted data, and assessed methodological quality, focusing on walking speed, endurance, and dependency.
Main Results:
- Forty-four trials involving 2658 participants were included. Treadmill training with BWsim did not significantly increase the likelihood of walking independently.
- However, it significantly improved walking velocity (mean difference 0.07 m/s) and endurance (mean difference 26.35 meters) during the intervention period.
- Improvements in walking endurance persisted in ambulatory patients post-stroke until the end of follow-up. No increase in adverse events or dropouts was observed.
Conclusions:
- Treadmill training with or without BWsim does not improve independent walking post-stroke but can enhance walking speed and endurance.
- Ambulatory stroke patients benefit most, with sustained improvements in walking endurance.
- Further research is recommended to explore optimal parameters (frequency, duration, intensity) for ambulatory patients.
