Effect of Speed-dependent Treadmill Training in Patients With Subacute Stroke
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Purpose
This study aimed to explore whether speed-dependent treadmill training is more effective at improving walking and balance performance than speed-stable treadmill training in patients with subacute stroke. Twenty-six patients with stroke completed 2 weeks of treadmill training. Results showed that speed-dependent treadmill training is more effective at improving walking speed and step length than speed-stable treadmill training in patients with subacute stroke.
| Condition | Intervention |
|---|---|
|
Stroke |
Other: Experimental Other: Speed-stable treadmill training |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Investigator) Primary Purpose: Treatment |
| Official Title: | Speed-dependent Treadmill Training is Effective to Improve Gait and Balance Performance in Patients With Sub-acute Stroke |
- change in Walking speed [ Time Frame: Change in walking speed from baseline to post-treatment, an expected average of 2 weeks ] [ Designated as safety issue: No ]
- change in stride length [ Time Frame: Change in stride length from baseline to post-treatment, an expected average of 2 weeks ] [ Designated as safety issue: No ]
- change in cadence [ Time Frame: Change in cadence from baseline to post-treatment, an expected average of 2 weeks ] [ Designated as safety issue: No ]
- change in Berg's balance score [ Time Frame: Change in Berg's balance score from baseline to post-treatment, an expected average of 2 weeks ] [ Designated as safety issue: Yes ]
| Enrollment: | 30 |
| Study Start Date: | December 2008 |
| Study Completion Date: | December 2009 |
| Primary Completion Date: | December 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Speed-dependent treadmill training (SDT)
Subjects underwent short interval of walking trials with stepwise increases in the treadmill speed
|
Other: Experimental
For SDT training, subjects received short intervals of locomotion training with a treadmill. After walking for 30s, the subjects were given two minutes of rest. If they completed the first walking trial safely and without stumbling, the belt speed was increased by 10% on the next trial. However, if a subject failed to complete the first trial, the belt speed was decreased by 10% on the next trial. The speed of the treadmill was adjusted in each subsequent trial according to the same principle. Subjects usually completed 7-8 walking trials in one session. The belt speed was increased by a maximum of five increments within one training session.
Other Name: Treadmill training with increasing speed
|
|
Active Comparator: speed-stable treadmill training
Control subjects received gait training on the treadmill with a steady speed.
|
Other: Speed-stable treadmill training
Subjects in the control group walked on the treadmill with the belt speed adjusted according to their fastest over-ground gait speed. There was no adjustment of the belt speed throughout the 30-minute steady-speed treadmill training session.
Other Name: Treadmill training with steady speed
|
Detailed Description:
Objectives: To compare the effects of speed-dependent treadmill training (SDT) on gait and balance performance in patients with sub-acute stroke. Design: Double-blinded randomized controlled trial. Subjects: Twenty-six patients with sub-acute stroke were randomly assigned to SDT (n=13) and control (n=13) groups. Methods: Subjects in the SDT group underwent short interval of walking trials with stepwise increases in the treadmill speed, following the principles of sprint training. Control subjects received gait training on the treadmill with a steady speed (SST). Gait speed, stride length, cadence, and Berg's balance score (BBS) were recorded and analysed before and after the 10 training sessions. Results: Results of two-way repeated measures ANOVA showed significant group x time interactions for gait speed and stride length (p < 0.05). Within each subject group, there were improvements in all gait parameters and BBS (all p < 0.001) after the training program. In addition, the SDT group showed significantly larger percentage increases in gait speed (by 72.8%) and stride length (by 29.2%) than the control subjects (p < 0.02). Conclusions: SDT in patients with sub-acute stroke resulted in larger gains in gait speed and stride length compared with SST. The positive findings provide evidence for clinical practice of SDT in enhancing gait function after stroke.
Eligibility| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- first episode of stroke
- within 1 month of stroke onset
- hemiparesis resulting from unilateral ischemic stroke
- Ashworth score of 0 or 1 indicating no spasticity or slight spasticity over the affected lower limb respectively
- mini-mental status examination score of ≥ 23
- the ability to walk on level ground without physical assistance and to walk on a treadmill with a minimum speed of 22.2 cm/s for 30s
Exclusion Criteria:
- neurological diseases other than stroke,
- active cardiovascular disease (i.e. American Heart Association class C or above),
- lower limb fractures
- total hip replacement
- active rheumatoid arthritis that affected their gait performance
- Patients who required assistance to ambulate before the stroke were also excluded
Contacts and Locations| China | |
| Margaret Mak | |
| Hong Kong, China | |
| Principal Investigator: | Margaret KY Mak, PhD | Department of Rehabilitation Sciences, The Hong Kong Polytechnic University |
More Information
No publications provided
| Responsible Party: | Dr. Margaret Mak, Department of Rehabilitation Sciences, The Hong Kogn Polytechnic University |
| ClinicalTrials.gov Identifier: | NCT01328301 History of Changes |
| Other Study ID Numbers: | mak0001 |
| Study First Received: | March 31, 2011 |
| Last Updated: | April 1, 2011 |
| Health Authority: | Hong Kong: Ethics Committee |
Keywords provided by The Hong Kong Polytechnic University:
|
gait hemiplegia treadmill physiotherapy rehabilitation |
Additional relevant MeSH terms:
|
Stroke Cerebral Infarction Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases Vascular Diseases Cardiovascular Diseases Brain Infarction Brain Ischemia Amphetamine Methamphetamine Central Nervous System Stimulants Physiological Effects of Drugs |
Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Sympathomimetics Autonomic Agents Peripheral Nervous System Agents Dopamine Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Adrenergic Agents Adrenergic Uptake Inhibitors Neurotransmitter Uptake Inhibitors Dopamine Uptake Inhibitors |
ClinicalTrials.gov processed this record on May 22, 2013