Journal
DISABILITY AND REHABILITATION
Volume 44, Issue 15, Pages 3760-3771Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/09638288.2021.1894247
Keywords
Overground walking; physical activity; stroke; treadmill walking; walking training
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Funding
- Association pour la Promotion de l'Education et de la Formation a l'Etranger (APEFE)
- Wallonie-Bruxelles International (WBI)
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The study found that treadmill walking training is more effective for balance and motor functions, while overground walking training has positive effects on walking endurance, walking speed, participation, and quality of life. Total training time did not significantly affect the effect sizes.
Purpose To review and quantify the effects of walking training for the improvement of various aspects of physical function of people with chronic stroke. Methods We conducted a systematic search and meta-analysis of randomized controlled trials (RCTs) of chronic stroke rehabilitation interventions published from 2008 to 2020 in English or French. Of the 6476-screened articles collated from four databases, 15 RCTs were included and analyzed. We performed a meta-regression with the total training time as dependent variable in order to have a better understanding of how did the training dosage affect the effect sizes. Results Treadmill walking training was more effective on balance and motor functions (standardized mean difference (SMD)=0.70[0.02, 1.37], p = 0.04) and 0.56[0.15, 0.96], p = 0.007 respectively). Overground walking training improved significantly walking endurance (SMD = 0.38[0.16, 0.59], p < 0.001), walking speed (MD = 0.12[0.05, 0.18], p < 0.001), participation (SMD = 0.35[0.02, 0.68], p = 0.04) and quality of life (SMD = 0.46[0.12, 0.80], p = 0.008). Aquatic training improved balance (SMD = 2.41[1.20, 3.62], p < 0.001). The Meta-regression analysis did not show significant effect of total training time on the effect sizes. Conclusion Treadmill and overground walking protocols consisting of >= 30 min sessions conducted at least 3 days per week for about 8 weeks are beneficial for improving motor impairments, activity limitations, participation, and quality of life in people with chronic stroke.
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