Abstract
BackgroundTreadmill training has been widely used for gait recovery after stroke. Gait re-establishment is one of the main objectives of rehabilitation programs after stroke, aiming to acquire more functional patterns and increase walking speed, along with improvement in cardiovascular function. The aim of this study is to evaluate the effects of a treadmill gait training protocol on functional and cardiovascular variables in patients with chronic stroke.MethodsA single-blind randomized clinical trial will be conducted. The sample will consist of 36 patients, who will be allocated in three groups: control group (n = 12), experimental group 1 (n = 12), and experimental group 2 (n = 12). The intervention will occur for 6 consecutive weeks, three times a week, 30 min each session, in all groups. The control group will perform a treadmill gait training without inclination, experimental group 1 will perform a treadmill gait training with anterior inclination of 5%, and experimental group 2 will perform a treadmill gait training with anterior inclination of 10%. All participants will be assessed for sample characterization measures, gait speed, functional capacity, systemic arterial blood pressure, heart rate, peripheral oxygen saturation, exercise capacity, neuromuscular torque, and quality of life. Evaluations of outcome measures will occur at the end of the interventions (post-training) and after 1 month and 1 year after the end of the interventions (short- and long-term follow-up). Statistical analysis will be performed descriptively and inferentially. Alpha equals 5% will be considered for inferential analysis. Mixed analysis of variance with repeated measures will be used to compare outcome measures between groups and between baseline, post-training, and follow-up. Normality test (Shapiro–Wilk) and subsequently t test (or Mann–Whitney) will be used to compare groups during the same training session.DiscussionIt is believed that treadmill training, especially treadmill training with anterior inclination, may result in improved exercise capacity in patients with stroke, reduced blood pressure and heart rate values, and an improvement in functional parameters with increased gait speed, functional capacity, quadriceps muscle torque, and quality of life.Trial registrationRegistration in Brazilian Registry of Clinical Trials (ReBEC) identifier RBR-5ffbxz, date of registration October 25 2017.
Highlights
Treadmill training has been widely used for gait recovery after stroke
It is believed that treadmill training, and especially inclined treadmill training, may result in an improvement in aerobic capacity in patients with stroke and in a reduction in heart rate (HR) and systemic arterial blood pressure values
It is expected that there will be an improvement in functional parameters, including increased gait speed and functional capacity, promoting ambulation with lower energy expenditure, improving performance in daily living activities, and reducing functional dependence of these individuals
Summary
Treadmill training has been widely used for gait recovery after stroke. Gait re-establishment is one of the main objectives of rehabilitation programs after stroke, aiming to acquire more functional patterns and increase walking speed, along with improvement in cardiovascular function. Stroke is an important cause of death and incapacity around the world, affecting about 795,000 individuals per year overall [1]. People affected by stroke commonly present motor or sensory changes (or both), unilateral or bilateral, loss of strength and coordination, visual and cognitive impairments, and perceptual and language deficits [5]. These changes promote difficulties in executing functional activities and reduced performance of daily living activities and a consequent reduction in social participation which can aggravate the presented clinical situation [6]. Other daily locomotion activities such as going up and down stairs, walking on sloped surfaces, and making turns and changing direction to return to a specific place or to avoid or go around obstacles are impaired as well
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