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Evidence summaries

Overground Physical Therapy Gait Training for Chronic Stroke Patients with Mobility Deficits

Overground physical therapy gait training is probably not effective in gait function in chronic stroke patients. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 9 studies with a total of 499 subjects. The patients had had a stroke at least 6 months earlier. Overground gait training refers to physical therapists' observation and cueing of the patient's walking pattern along with related exercises, but does not include high-technology aids such as functional electrical stimulation or body weight support. There was no evidence for a benefit of the primary variable, post-test gait function (3 studies, 269 participants). Of secondary variables, immediately after training gait speed increased by 0.07 metres per second (95% CI 0.05 to 0.10; 7 studies, 396 participants), timed up-and-go (TUG) test improved by 1.81 seconds (95% CI -2.29 to -1.33), and six-minute-walk test (6MWT) increased by 26.1 metres (95% CI 7.14 to 44.97) (4 studies, 181 participants). At the 3-month follow up, no significant effects were evident among the secondary variables.

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in population and interventions) and imprecise results (few patients, wide confidence intervals).

References

  • States RA, Pappas E, Salem Y. Overground physical therapy gait training for chronic stroke patients with mobility deficits. Cochrane Database Syst Rev 2009 Jul 8;(3):CD006075. [PubMed]

Primary/Secondary Keywords