Study yields promising results for patients with stroke

February 11, 2011, American Physical Therapy Association

One year after having a stroke, 52% of people who participate in either a physical therapy program that includes a walking program using a body-weight supported treadmill or a home-based program focused on progressive strength and balance exercises experience improved functional walking ability, according to the results of the Locomotor Experience Applied Post-stroke (LEAPS) trial being presented today at the American Stroke Association's International Stroke Conference 2011 in Los Angeles, and tomorrow at the American Physical Therapy Association's (APTA) 2011 Combined Sections Meeting in New Orleans.

The LEAPS trial, led by physical therapist and APTA member Pamela W. Duncan, PT, PhD, included 408 participants (average age 62) with recent stroke recruited from 6 US stroke rehabilitation centers between April 2006 and June 2009. Participants were 45% female, 58% Caucasian, 22% African American, and 13% Asian. All were assigned to 36 sessions of 75 to 90 minutes for 12 to 16 weeks in either a structured and progressive task-specific walking program that included body weight supported treadmill training provided early (2 months post-stroke) or late (6 months post-stroke), or a structured and progressive home-based exercise program of strength and balance provided 2 months post-stroke.

"The investigators hypothesized that the body-weight supported treadmill and walking program, especially early locomotor training, would be superior to a home exercise program; However at 1 year, the early walking group, late walking group, and exercise program targeting strength and balance achieved similar important gains in walking speed, motor recovery, balance, functional status, and quality of life," said Duncan, professor at Duke University School of Medicine in Durham, North Carolina. "Additionally, walkers with severe and moderate limitations improved with all programs. In all groups, the biggest improvements in outcomes were made after the first 12 sessions of therapy, but 13% of the subjects continued to make functional gains in walking recovery by 24 sessions and another 7% improved by 30 to 36 sessions."

Individuals in the locomotor training groups were more likely to feel faint and dizzy during the exercise, and those who received early locomotor training experienced more multiple falls. Fifty-seven percent of all participants experienced 1 fall, 34% had multiple falls, and 6% had a fall resulting in injury. Falls are a common problem among stroke survivors, and the investigators say this study builds on evidence that additional research is needed to prevent falls.

A secondary finding of the study shows that at 6 months post-stroke, a group who had not yet received any therapy beyond usual care showed improved walking speed, but only about half as much as the participants who received either the walking or home-based program at 2 months. The 6-month findings, according to Duncan and colleagues, suggest that both programs are effective forms of and are superior to usual care provided according to current standards of practice.

In the United States, nearly 800,000 people suffer a each year and 2/3 of survivors have limited ability after 3 months, says Duncan. "The bottom line is that patients recover faster and sustain recovery when the intervention is given early."

Related Stories

Recommended for you

Ambitious global virome project could mark end of pandemic era

February 23, 2018
Rather than wait for viruses like Ebola, SARS and Zika to become outbreaks that force the world to react, a new global initiative seeks to proactively identify, prepare for and stop viral threats before they become pandemics.

Forecasting antibiotic resistance with a 'weather map' of local data

February 23, 2018
The resistance that infectious microbes have to antibiotics makes it difficult for physicians to confidently select the right drug to treat an infection. And that resistance is dynamic: It changes from year to year and varies ...

Study reveals how kidney disease happens

February 22, 2018
Monash researchers have solved a mystery, revealing how certain immune cells work together to instigate autoimmune kidney disease.

Scientists gain new insight on how antibodies interact with widespread respiratory virus

February 22, 2018
Scientists have found and characterized the activity of four antibodies produced by the human immune system that target an important protein found in respiratory syncytial virus (RSV), according to new research published ...

Past encounters with the flu shape vaccine response

February 20, 2018
New research on why the influenza vaccine was only modestly effective in recent years shows that immune history with the flu influences a person's response to the vaccine.

Building better tiny kidneys to test drugs and help people avoid dialysis

February 16, 2018
A free online kidney atlas built by USC researchers empowers stem cell scientists everywhere to generate more human-like tiny kidneys for testing new drugs and creating renal replacement therapies.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.