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Sequenzeffekte in der laufbandtherapie (Treadmill training in early poststroke patients -- do timing and walking ability matter?) [German]
Scheidtmann K, Brunner H, Muller F, Weinandy-Trapp M, Wulf D, Koenig E
Neurologie und Rehabilitation 1999;5(4):198-202
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

The restitution of gait is a major challenge during the rehabilitation of hemiparetic patients. We investigated the influence of three weeks of treadmill training combined with physiotherapy, 30 minutes daily, followed by three weeks physiotherapy 30 minutes twice per day and vice versa. Patients were included early (58 +/- 29 days) after stroke. We used the Rivermead Motor Assessment score and a newly developed scale for qualitative gait parameters and we demonstrate that two times 30 minutes physiotherapy (PT) daily followed by 30 minutes treadmill training (LB) plus 30 minutes physiotherapy (PT-LB) daily was significantly more effective than the reverse order (LB-PT). By the end of the study 75% of the PT-LB patients were ambulatory, while only 36% of the LB-PT were able to walk. We hypothesize that the observed difference is due to an improvement of postural stability by intensive physiotherapy in the first phase which leads to a significant improvement of the quantitative and the qualitative gait parameters during treadmill training.

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