Treadmill training and body weight support for walking after stroke

Moseley, Anne M.; Stark, Angela; Cameron, Ian D.; Pollock, Alex

doi:10.1002/14651858.cd002840.pub2

Cited by 236 publications

(190 citation statements)

References 62 publications

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“…More data are needed to make it possible to assess whether this approach can improve walking among patients who persistently walk poorly at three to six months after a stroke, when gains have reached an apparent plateau after conventional therapy. 41 Exercise and Strengthening-In patients with hemiparesis, the rates of production of muscle force, power, speed of sequential movements, and resistance to fatigue are impaired. Although neural factors that affect motor control account for much of the impairment, changes in muscle fibers and atrophy induced by inactivity may contribute.…”

Section: Targeted Therapymentioning

confidence: 99%

Rehabilitation after Stroke

2005

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A 66-year-old man was suddenly unable to speak, follow directions, or move his right arm and leg. He received tissue plasminogen activator within 90 minutes. Four days later, his speech was limited to effortful answers of yes or no. He could not walk or use his right arm, and self-care tasks required maximal assistance. What advice would you offer him and his family regarding rehabilitation for his disabilities? THE CLINICAL PROBLEMApproximately 400 persons per 100,000 population over the age of 45 years have a first stroke each year in the United States, Europe, and Australia. Stroke is the most frequent cause of adult-onset disability among people in the United States, and the cost of related care is among the fastest-growing expenses for Medicare. 1 The likelihood of improvement after stroke varies with the nature and severity of the initial deficit. Approximately 35 percent of survivors with initial paralysis of the leg do not regain useful function, and 20 to 25 percent of all survivors are unable to walk without full physical assistance. 2 Six months after stroke, about 65 percent of patients cannot incorporate the affected hand into their usual activities. Poor upper-extremity outcomes are probable after a hemispheric infarction when the leg cannot move by two weeks and the hand has no movement or only slight finger flexion with no opening by four weeks, consistent with considerable damage to the corticospinal tract. 3 Patients who survive a stroke almost always have less physical disability by the end of the first three months. Functional scales, such as the Barthel Index and the Functional Independence Measure (which measure the physical assistance or supervision needed for self-care, including using the toilet, dressing, bathing, eating, and mobility), tend to show a plateau of gains by three to four months after stroke, partly owing to insensitivity of the scale to further improvements. Patients who no longer require assistance at that point may still be unable to use the affected hand, walk at speeds and distances that permit activities outside the home, or live alone. Only 25 percent of patients return to the level of everyday participation and physical functioning of community-matched persons who have not had a

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Section: Targeted Therapymentioning

confidence: 99%

Rehabilitation after Stroke

2005

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“…Treadmill gait training enhances the muscle strength and balance ability of the lower extremities 17,18) , and has been reported to be a more effective method than classic approaches stressing independent elements of gait 19,20) . However, there have been conflicting reports about the effects of treadmill gait training.…”

Section: Discussionmentioning

confidence: 99%

“…OGT improves the body's ability to generate muscle strength in the lower extremities and ground reaction force during movement 22) , while TGT enhances gait symmetry, coordination ability, and muscle strength of the lower extremities through repetitive movement of the lower extremities 19,20) . This study conducted OCT and TGT after dividing the subjects into a slow gait group (0.5 m/s or slower) and a fast gait group (faster than 0.5 m/s) 8) .…”

Section: Discussionmentioning

confidence: 99%

A Comparison of the Effects of Overground Gait Training and Treadmill Gait Training According to Stroke Patients’ Gait Velocity

et al. 2013

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Abstract.[Purpose] The purpose of this study was to compare the effects of overground gait training (OGT) and treadmill gait training (TGT) on walking speed, gait endurance, and balance ability of subjects with stroke. [Subjects and Methods] The study subjects were 40 patients with stroke. They were randomly divided into two groups, the OGT group and the TGT group, and further categorized according to their individual walking speeds (slow <0.5 m/s and fast >0.5 m/s). The groups performed exercises 10 times for a week. Pre-and post-test assessments involved the measurement of walking speed, walking endurance, and balance ability, as assessed by the 10-m walking time, the 6-min walking distance, and the Berg Balance Scale (BBS).[Results] The 10-m walking times, 6-min walking distance, and BBS scores of both the OGT group and the TGT group significantly improved, but there were no significant differences between the two groups. In the slow walking speed group, the OGT subjects showed significant improvement compared to the TGT subjects in the 6-min walk test.[Conclusion] Overall, we conclude that OGT was more effective at improving the gait endurance of stroke patients than TGT. Further research is needed to verify the generalizability of these findings and to identify which stroke patients might benefit from OGT.

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“…Treadmill exercise training as a means of motor function recovery has been applied widely and clinically and its effect has been studied for many years [8], [9]. However, its effect on motor function recovery and neuroprotection was controversial in recent years.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, it is in great demand to find out a better way to help the disabled recover their motor function for regaining self-living skills to relieve the burden of the society and their families. Treadmill exercise, a kind of conventional and easy-to-think-of means, has been used and studied [8], [9] for many years. It is universally used in the subacute stroke period because this phase is the golden period for treatment and recovery [10].…”

Section: Introductionmentioning

confidence: 99%

Treadmill Exercise Facilitates Functional Recovery and Neuroprotection in Subacute Stroke Rat

Sun¹,

Tong²,

Zheng³

et al. 2013

IJBBB

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Abstract-Treadmill exercise has been a controversial method to help stroke rat with functional recovery and neuroprotection. In this study, we investigated the effect of treadmill exercise on focal brain ischemia stroke rat in subacute phase. Twelve rats were induced focal ischemic stroke by a 60 min middle cerebral artery occlusion/reperfusion surgery and then randomly divided into two group, control group (CG, n=6) and treadmill group (TG, n=6). TC rats received daily treadmill exercise training during the seven-day experimental period while CG rats did not receive any intervention. Daily functional test results were recorded and all rats were sacrificed for TTC staining on the 7 th day. The increase rate of behaviour score in TG is significantly higher than that in CG (P<0.05) and the infarct volume in TG is significantly smaller than that in CG (P<0.05). Results illustrated that post-stroke treadmill exercise can facilitate the functional recovery and provide neuroprotection in focal ischemic stroke rat in the subacute phase.Index Terms-Focal ischemic, MCAo, stroke rat, treadmill exercise.

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Treadmill training and body weight support for walking after stroke

Cited by 236 publications

References 62 publications

Rehabilitation after Stroke

Rehabilitation after Stroke

A Comparison of the Effects of Overground Gait Training and Treadmill Gait Training According to Stroke Patients’ Gait Velocity

Treadmill Exercise Facilitates Functional Recovery and Neuroprotection in Subacute Stroke Rat

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