Effectiveness of gait training using an electromechanical gait trainer, with and without functional electric stimulation, in subacute stroke: a randomized controlled trial.
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.


METHODS
Nonblinded randomized controlled trial.


METHODS
Rehabilitation hospital for adults.


METHODS
Fifty patients were recruited within 6 weeks after stroke onset; 46 of these completed the 4-week training period.


METHODS
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.


METHODS
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 vs EGT, P=.011; CGT vs EGT-FES, P=.001), Motricity Index (CGT vs EGT-FES, P=.011), EMS (CGT vs EGT, P=.006; CGT vs EGT-FES, P=.009), and FAC (CGT vs EGT, P=.005; CGT vs EGT-FES, P=.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.
Tong
Raymond K
RK
Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hong Kong. k.y.tong@polyu.edu.hk
Ng
Maple F
MF
Li
Leonard S
LS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004599:Electric Stimulation Therapy; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016138:Walking