Overground gait training for individuals with chronic stroke: A Cochrane systematic review

Rebecca A. States, Yasser Salem, Evangelos Pappas

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background and Purpose: Overground gait training-observation and cueing of patient's walking pattern along with related exercises-forms a major part of rehabilitation services for individuals with chronic stroke in almost every setting. This report of a Cochrane systematic review assessed the effects of overground gait training on walking ability for individuals with mobility deficits subsequent to chronic stroke. Data Sources: We searched the Cochrane Stroke Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, Science Citation Index Expanded, http://www.clinicaltrials.gov, among other databases through spring 2008. We also searched reference lists and contacted authors and trial investigators. Review Methods: Only randomized controlled trials comparing overground physical therapy gait training with a placebo or no treatment condition were included. Results: Nine studies involving 499 participants were included. We found no evidence of a benefit on walking function, the primary variable, based on three studies (n = 269). Some performance variables did show significant effects. Walking speed increased by 0.07 m/sec [95% confidence interval (CI), 0.05-0.10] based on seven studies (n = 396), Timed Up and Go test improved by 1.81 seconds (95% CI, -2.29 to -1.33) based on three studies (n = 118), and six-minute walk test increased by 26.06 m (95% CI, 7.14-44.97) based on four studies (n = 181). Conclusions: We found insufficient evidence to determine whether overground physical therapy gait training benefits walking function in individuals with chronic stroke, although limited evidence suggests potential benefits for some performance variables. High-quality randomized controlled trials are needed to replicate and extend these findings.

Original languageEnglish
Pages (from-to)179-186
Number of pages8
JournalJournal of Neurologic Physical Therapy
Volume33
Issue number4
DOIs
StatePublished - 1 Dec 2009

Fingerprint

Gait
Walking
Stroke
Confidence Intervals
Randomized Controlled Trials
Information Storage and Retrieval
MEDLINE
Therapeutics
Rehabilitation
Placebos
Research Personnel
Observation
Databases
Exercise

Keywords

  • Ambulation
  • Locomotor training
  • Meta-analysis
  • Stroke
  • Systematic review
  • Walking

Cite this

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title = "Overground gait training for individuals with chronic stroke: A Cochrane systematic review",
abstract = "Background and Purpose: Overground gait training-observation and cueing of patient's walking pattern along with related exercises-forms a major part of rehabilitation services for individuals with chronic stroke in almost every setting. This report of a Cochrane systematic review assessed the effects of overground gait training on walking ability for individuals with mobility deficits subsequent to chronic stroke. Data Sources: We searched the Cochrane Stroke Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, Science Citation Index Expanded, http://www.clinicaltrials.gov, among other databases through spring 2008. We also searched reference lists and contacted authors and trial investigators. Review Methods: Only randomized controlled trials comparing overground physical therapy gait training with a placebo or no treatment condition were included. Results: Nine studies involving 499 participants were included. We found no evidence of a benefit on walking function, the primary variable, based on three studies (n = 269). Some performance variables did show significant effects. Walking speed increased by 0.07 m/sec [95{\%} confidence interval (CI), 0.05-0.10] based on seven studies (n = 396), Timed Up and Go test improved by 1.81 seconds (95{\%} CI, -2.29 to -1.33) based on three studies (n = 118), and six-minute walk test increased by 26.06 m (95{\%} CI, 7.14-44.97) based on four studies (n = 181). Conclusions: We found insufficient evidence to determine whether overground physical therapy gait training benefits walking function in individuals with chronic stroke, although limited evidence suggests potential benefits for some performance variables. High-quality randomized controlled trials are needed to replicate and extend these findings.",
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Overground gait training for individuals with chronic stroke : A Cochrane systematic review. / States, Rebecca A.; Salem, Yasser; Pappas, Evangelos.

In: Journal of Neurologic Physical Therapy, Vol. 33, No. 4, 01.12.2009, p. 179-186.

Research output: Contribution to journalArticle

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AU - Salem, Yasser

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