A task-orientated intervention enhances walking distance and speed in the first year post stroke: a randomized controlled trial.
OBJECTIVE
To evaluate the efficacy of a task-orientated intervention in enhancing competence in walking in people with stroke.


METHODS
Two-centre observer-blinded stratified block-randomized controlled trial.


METHODS
General community.


METHODS
Between May 2000 and February 2003, 91 individuals with a residual walking deficit within one year of a first or recurrent stroke consented to participate.


METHODS
The experimental intervention comprised 10 functional tasks designed to strengthen the lower extremities and enhance walking balance, speed and distance. The control intervention involved the practice of upper extremity activities. Subjects in both groups attended sessions three times a week for six weeks.


METHODS
Six-minute walk test (SMWT), 5-m walk (comfortable and maximum pace), Berg Balance Scale, timed 'up and go'.


RESULTS
At baseline, subjects in the experimental (n = 44) and control (n = 47) groups walked an average distance of 209 m (SD = 126) and 204 m (SD =131), respectively, on the SMWT. Mean improvements of 40 m (SD =72), and 5 m (SD =66) were observed following the experimental and control interventions, respectively. The between-group difference was 35 m (95% confidence interval (CI) 7, 64). Significant between-group effects of 0.21 m/s (95% CI 0.12, 0.30) and of 0.11 m/s (95% CI 0.03, 0.19) in maximum and comfortable walking speed, respectively, were observed. People with a mild, moderate or severe walking deficit at baseline improved an average of 36 (SD =96), 55 (SD = 56) and 18 m (SD = 23), respectively, in SMWT performance following the experimental intervention.


CONCLUSIONS
Study findings support the efficacy of a task-orientated intervention in enhancing walking distance and speed in the first year post stroke, particularly in people with moderate walking deficits.
Department of Epidemiology and Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
N M
NM
Salbach
N E
NE
Mayo
S
S
Wood-Dauphinee
J A
JA
Hanley
C L
CL
Richards
R
R
Côté
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology / Q000534:rehabilitation*; D006429:Hemiplegia / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016138:Walking / Q000502:physiology*