Effects of Visual Feedback During Recumbent Stepping in Individuals With Chronic Stroke.
Vicky Pardo, Morgan Albertson, Marina Bacus and 3 others
PMID 33543109WHAT IT FOUND
Eleven people with chronic stroke improved sit-to-stand speed and fast-walking stride length after eight sessions on a recumbent stepper that displayed real-time left-right effort.
Because there was no control group, it is impossible to say whether the visual feedback itself caused these gains.
Key findings
01Sit-to-stand time dropped from a mean of 32.0 to 17.8 seconds, a change that reached statistical significance with a large effect size.
02Fast-walking stride length increased on both the affected and unaffected legs, and step length on the unaffected leg, but no strength measure changed significantly.
03The single-group design means the study cannot determine whether the visual feedback enhanced outcomes or whether similar changes would have occurred without it.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study used a single-group pretest-posttest design with no control or comparison group, making it impossible to separate the effect of visual feedback from the effect of the exercise itself. The sample size was very small (eleven participants), and the authors state that time constraints impeded a larger sample. Participants were higher-functioning, with all but one reporting exercise more than 30 minutes three times per week, which limits generalizability to more impaired or sedentary stroke survivors. One participant was a potential outlier for the sit-to-stand test, improving from 187 to 74 seconds, while the other ten had scores below 31 seconds both pre- and post-intervention. Student research assistants administered the training sessions, and the authors acknowledge possible differences across participants and researchers that could have affected the results.
Declared interests
The paper does not report a funding source or a conflict of interest statement.
The easy way to misread this
Do not conclude that the visual feedback screen caused the improvements. The study had no control group, so the authors explicitly state they cannot determine if similar changes would have been seen without the feedback. The gains may be attributable to the recumbent stepping exercise itself.