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Published Online
on November 15, 2007

Stroke. 2007
Published online before print November 15, 2007, doi: 10.1161/STROKEAHA.107.495705
A more recent version of this article appeared on January 1, 2008
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*Stroke
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Right arrow Exercise/exercise testing/rehabilitation

Submitted on June 6, 2007
Accepted on June 27, 2007

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

Maple F.W. Ng BSc; Raymond K.Y. Tong PhD*; and Leonard S.W. Li MD

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.

* To whom correspondence should be addressed. 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’ {lambda}=0.743, P=0.005), FAC (Wilks’ {lambda}=0.744, P=0.005) and gait speed (Wilks’ {lambda}=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




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