Locomotor Training and Strength and Balance Exercises for Walking Recovery Post Stroke: Response to Number of Training Sessions

Published: August 22nd, 2017

Category: News and Events

Congratulations Dr. Stephen Nadeau on the publication of “Locomotor Training and Strength and Balance Exercises for Walking Recovery Post Stroke: Response to Number of Training Sessions,” which was published in the August edition of  Physical Therapy.

Abstract

Background: Evidence-based guidelines are needed to inform rehabilitation practice including the effect of number of exercise training sessions on recovery of walking ability post-stroke.

Objective: The objective of this study was to determine the effect of 2 interventions—locomotor training and strength and balance exercises—on poststroke walking recovery.

Design: This is a secondary analysis of the Locomotor Experience Applied Post-Stroke (LEAPS) randomized controlled trial.

Setting: Six rehabilitation sites in California and Florida and participants’ homes were used.

Patients: Participants were community-dwelling adults (N = 347) who had stroke, were able to walk at least 10 feet with assistance, and had completed the required number of intervention sessions.

Intervention: Participants received 36 sessions (3 times/wk for 12 wk), 90 minutes in duration, of locomotor training (gait training on a treadmill with body-weight support and over ground training) or strength and balance training.

Measurements: Walking speed, as measured by the 10-meter walk and 6-minute walk distance, were assessed before training and following 12, 24, and 36 intervention sessions.

Results: Participants at 2 and 6 months post stroke gained in gait speed and walking endurance following up to 36 sessions of treatment, but rate of gain diminished steadily and, on average, was very low during the 25 to 36 session epoch, regardless of treatment type or severity of impairment.

Limitations: Results may not generalize to patients who are unable to initiate a step at 2 months post stroke or patients with severe cardiac disease.

Conclusions: In general, community-dwelling individuals at both 2 and 6 months post stroke improve gait speed and walking distance with up to 36 sessions of locomotor training or strength and balance exercise. However, gains beyond 24 sessions tend to be very modest and tracking of individual response trajectory is imperative in planning treatment.