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(Stroke. 2008;39:154.)
© 2008 American Heart Association, Inc.

Original Contributions

A Pilot Study of Randomized Clinical Controlled Trial of Gait Training in Subacute Stroke Patients With Partial Body-Weight Support Electromechanical Gait Trainer and Functional Electrical Stimulation

Six-Month Follow-Up

From the Department of Health Technology and Informatics (M.F.W.N., R.K.Y.T.), The Hong Kong Polytechnic University, Hong Kong; and the Department of Medicine (L.S.W.L), Tung Wah Hospital, Hong Kong University, Hong Kong, China.

Correspondence to Raymond K.Y. Tong, PhD, Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong. E-mail k.y.tong{at}polyu.edu.hk

Background and Purpose— This study aimed to assess the effectiveness of gait training using an electromechanical gait trainer with or without functional electrical stimulation for people with subacute stroke.

Methods— This was a nonblinded randomized controlled trial with a 6-month follow-up. Fifty-four subjects were recruited within 6 weeks after stroke onset and were randomly assigned to 1 of 3 gait intervention groups: conventional overground gait training treatment (CT, n=21), electromechanical gait trainer (GT, n=17) and, electromechanical gait trainer with functional electrical stimulation (GT-FES, n=16). All subjects were to undergo an assigned intervention program comprising a 20-minute session every weekday for 4 weeks. The outcome measures were Functional Independence Measure, Barthel Index, Motricity Index leg subscale, Elderly Mobility Scale (EMS), Berg Balance Scale, Functional Ambulatory Category (FAC), and 5-meter walking speed test. Assessments were made at baseline, at the end of the 4-week intervention program, and 6 months after the program ended.

Results— By intention-to-treat and multivariate analysis, statistically significant differences showed up in EMS (Wilks’ =0.743, P=0.005), FAC (Wilks’ =0.744, P=0.005) and gait speed (Wilks’ =0.658, P<0.0001). Post hoc analysis (univariate 2-way ANCOVA) revealed that the GT and GT-FES groups showed significantly better improvement in comparison with the CT group at the end of the 4 weeks of training and in the 6-month follow-up.

Conclusions— For the early stage after stroke, this study indicated a higher effectiveness in poststroke gait training that used an electromechanical gait trainer compared with conventional overground gait training. The training effect was sustained through to the 6-month follow-up after the intervention.

Key Words: electrical stimulation • exercise therapy • gait • randomized clinical trial • rehabilitation