Rehabilitation interventions to improve locomotor outcome in chronic stroke survivors: A prospective, repeated-measure study.

Abstract

To ascertain whether rehabilitation interventions improve locomotion beyond 6 months post stroke. Site: The Neurological Rehabilitation Department of a university tertiary research hospital. Prospective, repeated-measure study. Patients with first episode of supra-tentorial stroke of more than 6 months duration. Twenty sessions of task-specific interventions consisting of lower limb resistive exercises and treadmill gait training to locomotor abilities (90 min/day, 5 days/week for 4 weeks). Evaluations were performed at the beginning and end of training and at a follow-up of 3 months. Stroke severity (Scandinavian Stroke Scale - SSS), balance (Berg Balance scale - BBS), ambulation (Functional Ambulation Category), walking ability (speed 10-m walk test - WS) and functional ability (Barthel Index - BI). Forty patients (32 men and eight women; age range: 22-65 years; mean post-stroke duration of 18.90 ± 12.76 months) were included in the study. Thirty-two (80.0%) patients completed their training and 28 (70.0%) patients reported at a follow up of 3-months. At the beginning, the end of training and at follow-up, the mean SSS scores were 41.71, 44.09, and 43.96; the BBS scores were 36.28, 46.75 and 46.82; the WS scores were 0.41, 0.53 and 0.51; and the BI scores were 77.34, 89.06 and 92.32, respectively. All outcome measures showed statistically significant improvement (P < 0.001) at the end of training and at follow-up. Rehabilitation interventions significantly improve locomotor outcome even in the chronic phase following a stroke.