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Aerobes laufbandtraining plus physiotherapie verbessert das gehen von massig schwer betroffenen patienten nach schlaganfall (Aerobic treadmill training plus physiotherapy improves walking speed and capacity in subacute, moderately affected patients after stroke) [German]
Hesse S, Eich HJ, Mach H, Parchmann H, Werner C
Neurologie und Rehabilitation 2005;11(1):7-12
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: to evaluate the immediate and long-term effect of aerobic treadmill plus physiotherapy in subacute stroke survivors as compared to physiotherapy alone. DESIGN: randomised controlled trial. SUBJECTS: 50 patients, first time supratentorial stroke, stroke interval < 8 weeks, Barthel Index (0 to 100) from 50 to 80, able to walk a minimum distance of 12 m with either intermittent help or stand-by while walking, cardiovascular stable, minimum 50 W in the bicycle ergometry, randomly allocated to two groups, A and B. INTERVENTIONS: Group A 30 min of treadmill training, harness secured and minimally supported according to patients' needs, and 30 min of physiotherapy, every workday for six weeks, speed and inclination of the treadmill were adjusted to reach a heart rate, HR = (HRmax - HRrest) x 0.6 + HRrest; in group B 60 min of daily physiotherapy for six weeks. MAIN OUTCOME MEASURES: Primary outcome variables were the absolute improvement of walking velocity (m/s) and capacity (m), secondary were gross motor functions including walking ability (score out of 13) and walking quality (score out of 41), blindly assessed before and after the intervention, and at follow-up 3 months later. RESULTS: Patients well tolerated the aerobic training, no side effects, significantly larger improvement of walking velocity and capacity both at study end (p = 0.001 res p = 0.002) and at follow-up (p = 0.000 res p = 0.000) in the experimental group. Between weeks 0 and 6, the experimental group had improved their walking speed and capacity for a mean of 0.31 m/s and 91 m, the control group for a mean of 0.16 m/s and 56 m. Between weeks 0 and 18, the experimental group had improved their walking speed and capacity for a mean of 0.36 m/s and 111 m, the control group for a mean of 0.15 m/s and 57 m. Gross motor functions and walking quality did not differ at any time. CONCLUSIONS: Aerobic treadmill training plus physiotherapy in subacute, moderately affected patients after stroke proved superior to physiotherapy alone with respect to the improvement of walking velocity and capacity.

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