Treadmill walking improves walking speed and distance in ambulatory people after stroke and is not inferior to overground walking: a systematic review.
Study Goal
The researchers aimed to determine if mechanically assisted walking (treadmill or gait trainer) improves walking speed, distance, and participation compared to no/non-walking intervention or overground walking in ambulatory adults after stroke, and whether benefits persist beyond the intervention period.
Results Summary
Treadmill walking increased walking speed by 0.13 m/s and distance by 46 m compared to no/non-walking intervention, with effects largely maintained post-intervention. It also showed similar or better effects on speed and distance compared to overground walking, though participation benefits were uncertain.
Population
Ambulatory adults at any time after stroke.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Treadmill walking | increase | walking speed | ambulatory adults after stroke | 0.13 m/s (95% CI 0.08 to 0.19) | increased | #1 |
Treadmill walking | increase | walking distance | ambulatory adults after stroke | 46 m (95% CI 24 to 68) | increased | #2 |
Treadmill walking | increase | walking speed | ambulatory adults after stroke | MD 0.07 m/s, 95% CI 0.00 to 0.13 | had a similar or better effect | #3 |
Treadmill walking | increase | walking distance | ambulatory adults after stroke | MD 18 m, 95% CI 1 to 36 | had a similar or better effect | #4 |
Treadmill walking | no change | participation | ambulatory adults after stroke | SMD 0.16, 95% CI -0.15 to 0.48 | estimate of the relative effect was very imprecise | #5 |
QUESTIONS: Does mechanically assisted walking improve walking speed, distance and participation compared with no/non-walking intervention or overground walking after stroke? Are any benefits maintained beyond the intervention period? DESIGN: Systematic review of randomised trials with meta-analysis. PARTICIPANTS: Ambulatory adults at any time after stroke. INTERVENTION: Mechanically assisted walking (treadmill or gait trainer) without body weight support. OUTCOME MEASURES: Walking speed, walking distance and participation. RESULTS: Sixteen trials involving 713 participants were included. The mean PEDro score of the trials was 6.3 (range 4 to 8). Treadmill walking increased walking speed by 0.13 m/s (95% CI 0.08 to 0.19) and distance by 46 m (95% CI 24 to 68) compared with no/non-walking intervention; these effects were largely maintained beyond the intervention. Treadmill walking had a similar or better effect on walking speed (MD 0.07 m/s, 95% CI 0.00 to 0.13) and distance (MD 18 m, 95% CI 1 to 36) compared with overground walking. The estimate of the relative effect of treadmill walking compared with overground walking on participation was very imprecise (SMD 0.16, 95% CI -0.15 to 0.48). CONCLUSION: This systematic review provides moderate-quality evidence that the effect of treadmill walking is the same as or better than the effect of overground walking for improving walking speed and distance in ambulatory people after stroke. Long-term effects and carryover benefits to participation remain uncertain. REVIEW REGISTRATION: PROSPERO (CRD42020162778).