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Effectiveness of gait training using an electromechanical gait trainer, with and without functional electric stimulation, in subacute stroke: a randomized controlled trial
Tong RK, Ng MF, Li LS
Archives of Physical Medicine and Rehabilitation 2006 Oct;87(10):1298-1304
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; 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 compare the therapeutic effects of conventional gait training (CGT), gait training using an electromechanical gait trainer (EGT), and gait training using an electromechanical gait trainer with functional electric stimulation (EGT-FES) in people with subacute stroke. DESIGN: Nonblinded randomized controlled trial. SETTING: Rehabilitation hospital for adults. PARTICIPANTS: Fifty patients were recruited within 6 weeks after stroke onset; 46 of these completed the 4-week training period. INTERVENTION: Participants were randomly assigned to 1 of 3 gait intervention groups: CGT, EGT, or EGT-FES. The experimental intervention was a 20-minute session per day, 5 days a week (weekdays) for 4 weeks. In addition, all participants received their 40-minute sessions of regular physical therapy every weekday as part of their treatment by the hospital. MAIN OUTCOME MEASURES: Five-meter walking speed test, Elderly Mobility Scale (EMS), Berg Balance Scale, Functional Ambulatory Category (FAC), Motricity Index leg subscale, FIM instrument score, and Barthel Index. RESULTS: The EGT and EGT-FES groups had statistically significantly more improvement than the CGT group in the 5-m walking speed test (CGT versus EGT, p = 0.011; CGT versus EGT-FES, p = 0.001), Motricity Index (CGT versus EGT-FES, p = 0.011), EMS (CGT versus EGT, p = 0.006; CGT versus EGT-FES, p = 0.009), and FAC (CGT versus EGT, p = 0.005; CGT versus EGT-FES, p = 0.002) after the 4 weeks of training. No statistically significant differences were found between the EGT and EGT-FES groups in all outcome measures. CONCLUSIONS: In this sample with subacute stroke, participants who trained on the electromechanical gait trainer with body-weight support, with or without FES, had a faster gait, better mobility, and improvement in functional ambulation than participants who underwent conventional gait training. Future studies with assessor blinding and larger sample sizes are warranted.

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