Article

Body-weight-supported treadmill training (BWSTT) to train both
fitness and ambulation has not been investigated.
OBJECTIVE: To compare the
effectiveness of BWSTT to dose-equivalent usual care (UC) in improving
cardiovascular fitness and walking early after stroke. METHODS: Participants were
randomly assigned to 1 of 2 interventions: BWSTT + UC or UC. All individuals
participated in 60-minute physiotherapy sessions 5 times weekly as inpatients for
6 weeks and 3 times weekly as outpatients for another 6 weeks. Baseline,
posttraining, 6-, and 12-month follow-up outcome measures were as follows:
primary, fitness (peak oxygen consumption, VO2peak) and walking ability (6-Minute
Walk Test [6MWT] and 10-m walk); secondary, Berg Balance Scale (BBS) and motor
impairment (Chedoke-McMaster Stages of Recovery [CMSR] Leg and Foot). RESULTS: In
all, 50 individuals (mean age, 60 +/- 14 years; mean event-to-randomization, 23
+/- 5 days; 29 men) participated. No adverse events occurred. BWSTT improved
VO2peak by 30%, which was significantly greater than the 8% improvement observed
for UC (P = .004 between groups). Similarly, there were significant Time x Group
interactions for 6MWT and CMSR Foot, with BWSTT outperforming UC for gains in
distance (P = .15; 48% vs. 19%, respectively) and stage (P = .01; 1.0 vs. 0.3,
respectively). No group effect was seen for 10-m walk speed, BBS, or CMSR Leg,
with both groups demonstrating significant gains. In general, gains observed were
preserved for 12 months. CONCLUSIONS: BWSTT elicits greater improvements in
cardiovascular fitness and walking endurance than UC in the subacute poststroke
period. These gains are largely sustained for 1 year.

Langue : ANGLAIS