title: Dual effects of body-weight supported treadmill training on cardiovascular fitness and walking ability early after stroke: a randomized controlled trial.
abstract: BACKGROUND
  Body-weight-supported treadmill training (BWSTT) to train both fitness and ambulation has not been investigated.
  
  
  OBJECTIVE
  To compare the effectiveness of BWSTT to dose-equivalent usual care (UC) in improving cardiovascular fitness and walking early after stroke.
  
  
  METHODS
  Participants were randomly assigned to 1 of 2 interventions: BWSTT + UC or UC. All individuals participated in 60-minute physiotherapy sessions 5 times weekly as inpatients for 6 weeks and 3 times weekly as outpatients for another 6 weeks. Baseline, posttraining, 6-, and 12-month follow-up outcome measures were as follows: primary, fitness (peak oxygen consumption, VO2peak) and walking ability (6-Minute Walk Test [6MWT] and 10-m walk); secondary, Berg Balance Scale (BBS) and motor impairment (Chedoke-McMaster Stages of Recovery [CMSR] Leg and Foot).
  
  
  RESULTS
  In all, 50 individuals (mean age, 60 ± 14 years; mean event-to-randomization, 23 ± 5 days; 29 men) participated. No adverse events occurred. BWSTT improved VO2peak by 30%, which was significantly greater than the 8% improvement observed for UC (P = .004 between groups). Similarly, there were significant Time × Group interactions for 6MWT and CMSR Foot, with BWSTT outperforming UC for gains in distance (P = .15; 48% vs. 19%, respectively) and stage (P = .01; 1.0 vs. 0.3, respectively). No group effect was seen for 10-m walk speed, BBS, or CMSR Leg, with both groups demonstrating significant gains. In general, gains observed were preserved for 12 months.
  
  
  CONCLUSIONS
  BWSTT elicits greater improvements in cardiovascular fitness and walking endurance than UC in the subacute poststroke period. These gains are largely sustained for 1 year.
authors.affiliation: School of Physiotherapy, Dalhousie University, Halifax, NS, Canada. m.mackay-lyons@dal.ca
authors.forename: Marilyn
authors.initials: M
authors.lastname: Mackay-Lyons
authors.forename: Alison
authors.initials: A
authors.lastname: McDonald
authors.forename: Jane
authors.initials: J
authors.lastname: Matheson
authors.forename: Gail
authors.initials: G
authors.lastname: Eskes
authors.forename: Mary-Anne
authors.initials: MA
authors.lastname: Klus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking
keywords: cardiovascular fitness; deconditioning; exercise therapy; hemiplegia; stroke rehabilitation; treadmill training; walking