Evidence for the effectiveness of walking training on walking and self-care after stroke: A systematic review and meta-analysis of randomized controlled trials

Peurala, Sinikka H.; Karttunen, Auli H; Sjögren, Tuulikki; Paltamaa, Jaana; Heinonen, Ari

doi:10.2340/16501977-1805

Cited by 45 publications

(35 citation statements)

References 108 publications

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“…In the chronic stage, walking training resulted in increased walking speed and walking distance compared with no/placebo treatment, and increased walking speed compared with overall physiotherapy. On average, 24 training sessions for 7 weeks were needed (Peurala et al., ).…”

Section: Cardiovascular Diseasesmentioning

confidence: 99%

Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases

Pedersen

Saltin

2015

Scandinavian Med Sci Sports

2,534

1,786

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This review provides the reader with the up‐to‐date evidence‐based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo‐skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.

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Section: Cardiovascular Diseasesmentioning

confidence: 99%

Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases

Pedersen

Saltin

2015

Scandinavian Med Sci Sports

2,534

1,786

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“…MRI for medical diagnosis13 ) . The main clinical presentation of stroke includes weakness in one side of the patient’s body resulting to walking difficulties14 ) .…”

Section: Discussionmentioning

confidence: 99%

“…Separate from conventional measurement tools regarding functional activities in daily living, majority of patients specifically reported their difficulties in walking14 ) . As a result, information about the use of assistive devices for walking such as wheelchair was frequently found.…”

Section: Discussionmentioning

confidence: 99%

Information on functioning found in the medical records of patients with stroke

2016

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[Purpose] To explore data on functioning in the medical records of patients with stroke by linking them to the ICF. [Subjects and Methods] The admission and discharge summaries of patients’ electronic medical records (EMRs) were investigated. Information on functioning included in the summaries were mapped into the ICF. Each of the linked categories of ICF was analyzed using frequency and percentage analysis. [Results] Thirty stroke patients’ records were evaluated. A total of 1,832 items on functioning in the EMRs were found to be linked to eighty-five categories of the ICF. The majority of those categories (52.9%) belonged to the body function domain, whereas only 8.2% were environment factors. Categories in the domain of activity and participation, and body structure were found to be 22.4% and 16.5% respectively. In each domain, the most frequently found categories were muscle power function (b730), structure of brain (s110), walking (d450), and products or substances for personal consumption (e110). [Conclusion] It was found that the admission and discharge summary in the current medical records of patients with stroke contained much noticeable information on functioning and the data on functioning may be linked to the ICF. Further study is needed to adapt ICF in Korean clinical settings.

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“…The principal outcome is walking speed, which is a widely used index in research and in rehabilitation clinics [16]. Furthermore, speed is a good predictor for a patient’s independence during daily life activities [7, 15]. As additional indexes of walking ability, we collect gait data during every training session, taking advantage of the embedded sensors in the treadmills.…”

Section: Methodsmentioning

confidence: 99%

“…It is likely that, in the case of stroke survivors specifically, strength training, overground walking training, and speed-dependent treadmill training can improve aspects of gait [13–16]. To be effective, walking training should occur with an average frequency of 3–5 times weekly, in sessions lasting from 20 to 60 min [15]. Concerning patients with incomplete SCI, strong evidence also exists that repeated walking exercises enhance locomotor recovery [6].…”

Section: Introductionmentioning

confidence: 99%

Visually-guided gait training in paretic patients during the first rehabilitation phase: study protocol for a randomized controlled trial

Rossano

Terrier

2016

Trials

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BackgroundAfter a lesion to the central nervous system, many patients suffer from reduced walking capability. In the first rehabilitation phase, repeated walking exercises facilitate muscular strength and stimulate brain plasticity and motor relearning. However, marked limping, an unsteady gait, and poor management of obstacle clearance may persist, which increases a patient’s risk of falling. Gait training with augmented reality has been recommended to improve gait coordination. The objective of this study is to test whether a gait rehabilitation program using augmented reality is superior to a conventional treadmill training program of equivalent intensity.Methods/designThe GASPAR trial (Gait Adaptation for Stroke Patients with Augmented Reality) is a pragmatic, parallel-arm, single-center, nonblind, superiority randomized control trial in neurorehabilitation. The setting is a rehabilitation clinic in Switzerland. The planned number of participants is 70–100. The intervention uses instrumented treadmills equipped with projectors that display shapes on the walking surface. The principle is that patients must adapt their gait to the image that unfolds in front of them. Specific exercises for gait symmetry, coordination enhancement, and gait agility are provided. The program includes twenty 30-min sessions spanning 4 weeks. The comparator group receives standard treadmill training of a similar frequency and intensity. The main outcome to be measured in the trial is walking speed, which is assessed with the 2-min Walk Test. Moreover, gait parameters are recorded during the gait training sessions. Other outcomes are balance control (Berg Balance Scale) and the fear of falling (Falls Efficacy Scale). The statistical analyses will compare the baseline assessment for each participant (before the intervention) with a post-intervention assessment (taken a few days after the end of the program). Furthermore, a follow-up assessment will take place 3 months after discharge.DiscussionThe study results will provide new knowledge about recovery in neurological patients and will contribute to the design of better rehabilitation programs to accompany this process. The findings will also help health care funders to decide whether treadmills equipped with augmented reality capabilities are a worthwhile investment.Trial registrationClinicalTrials.gov ID: NCT02808078, registered on 16 June 2016.

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Evidence for the effectiveness of walking training on walking and self-care after stroke: A systematic review and meta-analysis of randomized controlled trials

Cited by 45 publications

References 108 publications

Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases

Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases

Information on functioning found in the medical records of patients with stroke

Visually-guided gait training in paretic patients during the first rehabilitation phase: study protocol for a randomized controlled trial

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