Therapy can help stroke patients walk
People who participate in physical therapy program experience improved functional walking ability.
A new study has found that structured and progressive treadmill walking and exercise programs for strength and balance yield similar results for patients one year after having stroke.
The study found that post-stroke, 52 per cent of people who participate in either a physical therapy program that includes a walking program using a body-weight supported treadmill or a home-based program focused on progressive strength and balance exercises experience improved functional walking ability.
The Locomotor Experience Applied Post-stroke (LEAPS) trial, led by physical therapist Pamela W. Duncan, included 408 participants with recent stroke.
"The investigators hypothesized that the body-weight supported treadmill and walking program, especially early locomotor training, would be superior to a home exercise program; However at one year, the early walking group, late walking group, and exercise program targeting strength and balance achieved similar important gains in walking speed, motor recovery, balance, functional status, and quality of life," said Duncan, of the Duke University School of Medicine in Durham, North Carolina.
"Additionally, walkers with severe and moderate limitations improved with all programs. In all groups, the biggest improvements in outcomes were made after the first 12 sessions of therapy, but 13 per cent of the subjects continued to make functional gains in walking recovery by 24 sessions and another 7 per cent improved by 30 to 36 sessions," he said.
Individuals in the locomotor training groups were more likely to feel faint and dizzy during the exercise, and those who received early locomotor training experienced more multiple falls.
Fifty-seven percent of all participants experienced one fall, 34 per cent had multiple falls, and six percent had a fall resulting in injury. Falls are a common problem among stroke survivors, and the investigators say this study builds on evidence that additional research is needed to prevent falls.
A secondary finding of the study shows that at six months post-stroke, a group who had not yet received any therapy beyond usual care showed improved walking speed, but only about half as much as the participants who received either the walking or home-based program at two months.
According to Duncan and colleagues, the six-month findings, suggest that both programs are effective forms of physical therapy and are superior to usual care provided according to current standards of practice.
The findings were presented at the American Stroke Association`s International Stroke Conference 2011 in Los Angeles.