+AA
Fr
Back
Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

Walking training helps to improve walking ability and possibly self-care after stroke

Peurala S, Karttunnen AH, Sjögren T, et al. Evidence for the effectiveness of walking training on walking and self-care after stroke: A systematic review and meta-analysis of randomized controlled trials J Rehabil Med. 2014;46:387-399.

Review question

Does walking training after a stroke improve a patient’s ability to walk and take care of themselves? Are specific walking training programs (using a treadmill or other types of walking training devices) more effective than traditional walking training (using walking aids such as walkers or canes) or physiotherapy?

Background

In many western countries, stroke is one of the main causes of disability and can have a large impact on daily activities such as the ability to get in and out of bed, dress and walk independently. Intensive physiotherapy starting soon after a stroke can help people recover better and faster. Few studies have looked at the benefits of walking training, but knowing more can help health professionals to design the best types of rehabilitation programs for people who have had a stroke.

How the review was done

The researchers conducted a systematic review of 38 randomized controlled trials of adult stroke patients. Only good or high quality studies were included in this review.  Walking training included walking with aids, walking on a treadmill or using other types of walking training devices and encouragement and guidance by a therapist. The review compared 3 rehabilitation sub-groups:

  • 7 studies compared walking training  to no treatment or placebo treatment
  • 11 studies compared walking training  to overall physiotherapy
  • 21 studies compared specific walking training programs  to traditional walking training

The researchers measured changes in walking speed, walking distance, walking independence and the patient’s ability to care for themselves to find out if walking training programs helped with stroke recovery.

What the researchers found

For patients 1 to 6 months after a stroke, specific walking training (including musical feedback and treadmill training) helped to improve walking speed and distance more than traditional walking training. For patients over 6 months after a stroke, any type of walking training helped improve walking ability, speed and distance compared to people receiving no treatment, placebo treatment or physiotherapy. On average, 20-60 min training sessions 3-5 times a week for at least 4 weeks were needed to make a difference. Walking training also appeared to have some benefit in improving patients’ ability to care for themselves.

Conclusion

Walking training improves walking speed, distance and ability – even many months after a stroke – and may help to improve patient self-care for people who have had a stroke. For walking training to be effective, sessions should be 3 to 5 times per week and last between 20 to 60 minutes.

 

 




Glossary

Placebo
A harmless, inactive, and simulated treatment.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

Related Web Resources

  • Dance therapy for people with cancer

    Evidently Cochrane
    Dance therapy does not appear to have a large benefit on improving physical or psychological symptoms of people with cancer, such as depression, fatigue or body image. However, you should dance if it helps you feel better.
  • After a stroke: Does fitness training improve health and mobility?

    Informed Health Online
    Fitness training after a stroke can improve physical fitness and mobility, but can require a lot of effort and motivation. Examples of fitness training include Nordic walking, treadmills, or exercise bikes.
  • Too fit to fracture: Managing osteoporosis through exercise

    Osteoporosis Canada
    If you have osteoporosis, it is recommended to exercise regularly. A physical therapist or kinesiologist can give you advice on what type of exercise is best for you. You should do a combination of strength, posture, balance, and aerobic exercise.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Register for free access to all Professional content

Register
Want the latest in aging research? Sign up for our email alerts.
Subscribe
© 2012 - 2019 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use