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Europa Medicophysica 2007 December;43(4):499-504

Copyright © 2007 EDIZIONI MINERVA MEDICA

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Can we improve gait skills in chronic hemiplegics? A randomised control trial with gait trainer

Dias D., Laíns J., Pereira A., Nunes R., Caldas J., Amaral C., Pires S., Costa A., Alves P., Moreira M., Garrido N., Loureiro L.

Clinic of Physical Medicine and Rehabilitation Gouveia, Portugal

Aim. Partial body weight support (PBWS) is an accepted treatment for hemiplegic patients. The aim of this study is to compare the efficiency of gait trainer with conventional treatment on the gait management after stroke.
Method. Forty chronic post-stroke hemiplegics were part of a prospective research. Inclusion criteria were: first ever stroke in a chronic stage with stabilised motor deficits; age >18 and <80 years; cognitive and communication skills to understand the treatment; absence of cardiac, psychological and orthopedic contraindications. Patients were randomised into two groups: the control group (CG) that used the Bobath method in 40 minutes sessions, 5 times a week, for 5 weeks, and the experimental group (EG) that used the gait trainer, for the same period of time and frequency. Assessment tools: Motricity Index (MI); Toulouse Motor Scale (TMS); modified Ashworth Spasticity Scale (mASS); Berg Balance Scale (BBS); Rivermead Mobility Index (RMI); Fugl-Meyer Stroke Scale (F-MSS); Functional Ambulation Category (FAC); Barthel Index (BI); 10 meters, time up and go (TUG), 6 minutes, and step tests. EG and CG did the assessments before treatment (T0), right after treatment (T1), and on follow-up, 3 months later (T2).
Results. CG and EG were homogenous in all the variables at T0. CG and EG showed improvement in almost all the assessment scales after treatment, although only some with relevant differences. EG showed statistically relevant improvement on T1 and on T2 in several of the assessment tools, whereas CG only showed statistically significant improvement after T1 and only in some of the assessment tools.
Conclusion. Both groups of chronic hemiplegic patients improved after either PBWS with gait trainer or Bobath treatment. Only subjects undergoing PBWS with gait trainer maintained functional gain after 3 months.