In the largest stroke rehabilitation study ever conducted in the United States, researchers found that stroke patients regain walking ability through at-home strength and balance exercise provided by a physical therapist — and that method worked just as well as when they participated in programs that practice the actual task of walking, by using a treadmill and partial body weight support.
"For individuals who have suffered a stroke, the findings of this trial offer good news for improving walking within the first year post-stroke through intense physical therapy interventions," said Andrea Behrman, co-principal investigator and an associate professor in the department of physical therapy at the University of Florida College of Public Health and Health Professions.
The Locomotor Experience Applied Post-Stroke, or LEAPS, trial included more than 400 patients who were randomly assigned to a treadmill training group two or six months after their stroke or to a home-based therapy program. Primary funding for the study came from the National Institute of Neurological Disorders and Stroke.
Patients in the walking training group practiced walking in a clinic, using a treadmill with a device that provides partial body-weight support, also known as locomotor training. The home-based exercise therapy program was supervised by a physical therapist and focused on flexibility, range of motion, strength and balance.
At the one-year mark, 52 percent of all the study participants had made significant improvements in their walking ability. Both the walking training and exercise program patients had similar improvements in walking speed, motor recovery, balance, social participation and quality of life.
But the home-based exercise program may save on health-care costs and promote treatment adherence: Only 3 percent of patients in the home-based therapy dropped out of the study while 13 percent discontinued the locomotor training.