Stroke patients in locomotor training improve as much as those in home exercise program
FRIDAY, Feb. 11 (HealthDay News) -- Stroke patients who undergo an early or late training program that requires the use of a body-weight supported treadmill device followed by walking practice demonstrate similar improvements in their walking abilities as those who undergo a home physical therapist-managed exercise program (HEP), and patients continue to improve up to a year post-stroke, according to research presented at the American Stroke Association's International Stroke Conference 2011, held from Feb. 9 to 11 in Los Angeles.
In the Locomotor Experience Applied Post-stroke study, Pamela W. Duncan, Ph.D., of Duke University in Durham, N.C., and colleagues randomized 408 patients to a locomotor training program (LTP) -- body weight-supported stepping on a treadmill either two months post-stroke or six months post-stroke -- or a control intervention, HEP. Each intervention included 36 90-minute sessions over 12 to 16 weeks.
The investigators found that all groups achieved similar gains in walking speed, motor recovery, balance, social participation, and quality of life. At one year, 52 percent of all the study participants had made significant improvements in their ability to walk, with the timing of the LTP not appearing to matter. The investigators also found no differences in the proportion of patients who improved walking with the early or late LTP. However, patients who were not assigned to a study group until six months after their stroke recovered only about half as much as the participants who received one of the two therapy programs at two months. In addition, the severity of stroke did not affect a patient's ability to make progress in recovery by the end of one year. Individuals in the LTP groups were more likely to feel faint and dizzy during exercise, and those who received early locomotor training experienced more falls.
"We were pleased to see that stroke patients who had a home physical therapy exercise program improved just as well as those who did the locomotor training," Duncan said in a statement. "The home physical therapy program is more convenient and pragmatic. Usual care should incorporate more intensive exercise programs that are easily accessible to patients to improve walking, function and quality of life."
One author disclosed financial relationships with GlaxoSmithKline, Allergan, Wyeth, and Accordia.
Abstract No. LB 11