Feasibility and effectiveness of repetitive gait training early after stroke: A systematic review and meta-analysis.
Study Goal
The researchers aimed to evaluate the feasibility and effectiveness of repetitive gait training within the first 3 months post-stroke compared to conventional therapy.
Results Summary
Repetitive gait training was found to be safe and feasible, with small but significant effects on walking independence and endurance. Training with end-effector robots appeared most effective.
Population
Individuals within the first 3 months post-stroke.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
repetitive gait training | no change | feasibility | patients early post-stroke | - | can safely be provided | #1 |
repetitive gait training | no change | drop-out rates | patients early post-stroke | - | No difference in drop-out rates was reported | #2 |
repetitive gait training | increase | walking independence | patients early post-stroke | small | yielded significant, but small, effects | #3 |
repetitive gait training | increase | endurance | patients early post-stroke | small | yielded significant, but small, effects | #4 |
Training with end-effector robots | increase | effectiveness | patients early post-stroke | - | appears most effective | #5 |
Robots | increase | quantity of walking practice | patients early post-stroke | substantial | enable a substantial, yet feasible, increase | #6 |
Robots enabling increased walking practice | increase | functional recovery | patients early post-stroke | - | might enhance | #7 |
BACKGROUND: Pre-clinical evidence suggests a period early after stroke during which the brain is most receptive to rehabilitation, if it is provided as high-dose motor training. OBJECTIVE: To evaluate the feasibility of repetitive gait training within the first 3 months post-stroke and the effects on gait-specific outcomes. METHODS: PubMed, Web of Science, Cochrane Library, Rehab Data and PEDro databases were searched systematically. Randomized controlled trials were included to descriptively analyse the feasibility and quantitatively investigate the effectiveness of repetitive gait training compared with conventional therapy. RESULTS: Fifteen randomized controlled trials were included. Repetitive training can safely be provided through body weight support and locomotor assistance from therapists or a robotic device. No difference in drop-out rates was reported despite the demanding nature of the intervention. The meta-analysis yielded significant, but small, effects on walking independence and endurance. Training with end-effector robots appears most effective. CONCLUSION: Robots enable a substantial, yet feasible, increase in the quantity of walking practice early post-stroke, which might enhance functional recovery. However, the mechanisms underlying these effects remain poorly understood.