title: Walking training with cueing of cadence improves walking speed and stride length after stroke more than walking training alone: a systematic review.
abstract: OBJECTIVE
  After stroke, is walking training with cueing of cadence superior to walking training alone in improving walking speed, stride length, cadence and symmetry?
  
  
  METHODS
  Systematic review with meta-analysis of randomised or controlled trials.
  
  
  METHODS
  Adults who have had a stroke.
  
  
  METHODS
  Walking training with cueing of cadence.
  
  
  METHODS
  Four walking outcomes were of interest: walking speed, stride length, cadence and symmetry.
  
  
  RESULTS
  This review included seven trials involving 211 participants. Because one trial caused substantial statistical heterogeneity, meta-analyses were conducted with and without this trial. Walking training with cueing of cadence improved walking speed by 0.23 m/s (95% CI 0.18 to 0.27, I(2)=0%), stride length by 0.21 m (95% CI 0.14 to 0.28, I(2)=18%), cadence by 19 steps/minute (95% CI 14 to 23, I(2)=40%), and symmetry by 15% (95% CI 3 to 26, random effects) more than walking training alone.
  
  
  CONCLUSIONS
  This review provides evidence that walking training with cueing of cadence improves walking speed and stride length more than walking training alone. It may also produce benefits in terms of cadence and symmetry of walking. The evidence appears strong enough to recommend the addition of 30 minutes of cueing of cadence to walking training, four times a week for 4 weeks, in order to improve walking in moderately disabled individuals with stroke.
  
  
  BACKGROUND
  PROSPERO (CRD42013005873).
authors.affiliation: Discipline of Physiotherapy, The University of Sydney, Australia; Discipline of Physiotherapy, Universidade Federal de Minas Gerais.
authors.forename: Lucas R
authors.initials: LR
authors.lastname: Nascimento
authors.affiliation: Discipline of Physiotherapy, The University of Sydney, Australia.
authors.forename: Camila Quel
authors.initials: CQ
authors.lastname: de Oliveira
authors.affiliation: Discipline of Physiotherapy, The University of Sydney, Australia.
authors.forename: Louise
authors.initials: L
authors.lastname: Ada
authors.affiliation: Discipline of Physiotherapy, Universidade do Estado de Santa Catarina, Brazil.
authors.forename: Stella M
authors.initials: SM
authors.lastname: Michaelsen
authors.affiliation: Discipline of Physiotherapy, Universidade Federal de Minas Gerais.
authors.forename: Luci F
authors.initials: LF
authors.lastname: Teixeira-Salmela
mesh_terms: D000328:Adult; D003463:Cues; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005684:Gait; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking
keywords: Cue; Gait; Meta-analysis; Stroke; Systematic review