Therapy Can Help Stroke Patients Walk, Even After 6 Months
Posted Feb 11 2011 12:00pm
Comparison study found intense training at home as good as high-tech treadmill device.
FRIDAY, Feb. 11 (HealthDay News) -- Stroke patients who do intense physical therapy at home achieve the same amount of improvement in their walking ability as those enrolled in a high-tech training program that uses a body-weight supported treadmill device, the results of a new study show.
The researchers also found that the walking ability of patients who do physical therapy continues to improve for up to one year after their stroke, which challenges the current belief that stroke recovery occurs early and peaks at six months.
Even patients who began rehabilitation as late as six months after their stroke were able to improve their walking, the study authors said.
This was the largest stroke rehabilitation study ever conducted in the United States, and included more than 400 patients, average age 62. Some were assigned to begin locomotor training two months after their stroke while others began at six months post-stroke.
Locomotor training, which involves having a patient walk on a treadmill in a harness that provides partial body-weight support, has grown increasingly popular. Upon completion of treadmill training, patients practice walking.
The patients in the two locomotor training groups were compared to patients who were assigned to a home exercise program managed by a physical therapist. The goal of this program was to enhance patients' flexibility, range of motion, strength and balance in order to improve their ability to walk.
When the patients were assessed one year after their stroke, 52 percent of all the participants had achieved significant improvements in their ability to walk. Patients in all three groups showed similar gains in the speed and distances of their walking, physical mobility, motor recovery and social participation, resulting in an improved quality of life, the researchers reported.
"More than 4 million stroke survivors experience difficulty walking. Rigorously comparing available physical therapy treatments is essential to determine which is best," Dr. Walter Koroshetz, deputy director of the U.S. National Institute of Neurological Disorders and Stroke (NINDS), said in an agency news release.
"The results of this study show that the more expensive, high-tech therapy was not superior to intensive home strength and balance training, but both were better than lower intensity physical therapy," he explained.
"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," principal investigator Pamela W. Duncan, a professor at Duke University School of Medicine, said in the NINDS news release. "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."
The study, which was primarily funded by NINDS, was released Friday at the American Stroke Association's International Stroke Conference in Los Angeles.
Experts note that research presented at meetings has not been subjected to the same type of rigorous scrutiny given to research published in peer-reviewed medical journals.