Article

Evidence-based guidelines are needed to inform rehabilitation
practice, including the effect of number of exercise training sessions on
recovery of walking ability after stroke. The objective of this study
was to determine the response to increasing number of training sessions 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.
Participants: Participants were adults who dwelled in the community (N=347), had
had a stroke, were able to walk at least 3 m (10 ft) with assistance, and had
completed the required number of intervention sessions. Intervention:
Participants received 36 sessions (3 times per week for 12 weeks), 90 minutes in
duration, of locomotor training (gait training on a treadmill with body-weight
support and overground training) or strength and balance training. Measurements:
Talking speed, as measured by the 10-Meter Walk Test, and 6-minute walking
distance were assessed before training and following 12, 24, and 36 intervention
sessions. Results: Participants at 2 and 6 months after stroke gained in gait
speed and walking endurance after up to 36 sessions of treatment, but the 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 people who are unable to initiate a
step at 2 months after stroke or people with severe cardiac disease. Conclusions:
In general, people who dwelled in the community showed improvements in gait speed
and walking distance with up to 36 sessions of locomotor training or strength and
balance exercises at both 2 and 6 months after stroke. However, gains beyond 24
sessions tended to be very modest.
The tracking of individual response
trajectories is imperative in planning treatment.

Langue : ANGLAIS