title: Treadmill training provides greater benefit to the subgroup of community-dwelling people after stroke who walk faster than 0.4m/s: a randomised trial.
abstract: OBJECTIVE
  After stroke, does treadmill training provide greater benefit to the subgroup of community-dwelling people who walk faster than 0.4m/s than those who walk more slowly?
  
  
  METHODS
  Subgroup analysis of a randomised trial: the AMBULATE trial.
  
  
  METHODS
  68 people with stroke living in the community.
  
  
  METHODS
  The experimental group received 30 minutes of treadmill and overground walking, three times a week for four months; the control group received no intervention.
  
  
  METHODS
  The primary outcome was walking distance covered during the six-minute walk test. Other outcomes were comfortable and fast walking speed and health status.
  
  
  RESULTS
  At four months, in the subgroup of participants with a baseline comfortable walking speed of > 0.4m/s, treadmill training produced an extra distance of 72m (95% CI 23 to 121) and an increased comfortable speed of 0.16m/s (95% CI 0.00 to 0.32), compared with the subgroup with a speed of ≤0.4m/s. There was also a trend towards an extra fast speed of 0.17m/s (95% CI -0.04 to 0.36). There was no extra effect of treadmill training in the faster walkers in terms of EuroQol 5Q-5D. There were no differences between the experimental and control groups between subgroups in the long term.
  
  
  CONCLUSIONS
  Treadmill training is more likely to benefit people who walk at a speed of > 0.4m/s. Clinicians should use comfortable walking speed to predict the potential for improvement and to guide intervention.
  
  
  BACKGROUND
  ACTRN12607000227493.
authors: Department of Health Professions, Macquarie University.
authors: Catherine M
authors: CM
authors: Dean
authors: Discipline of Physiotherapy, The University of Sydney.
authors: Louise
authors: L
authors: Ada
authors: Discipline of Medicine, Westmead Clinical School, The University of Sydney, Australia.
authors: Richard I
authors: RI
authors: Lindley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005080:Exercise Test; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D026741:Physical Therapy Modalities; D020127:Recovery of Function / Q000502:physiology; D012111:Residence Characteristics; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*
keywords: Cerebrovascular accident; Community participation; Randomised controlled trial; Rehabilitation; Stroke