Treadmill training to improve mobility for people with sub-acute stroke: a phase II feasibility randomized controlled trial.
Gillian D Baer, Lisa G Salisbury, Mark T Smith and 2 others
PMID 28730849WHAT IT FOUND
Adding treadmill training to usual physiotherapy did not improve mobility more than usual physiotherapy alone, and the treadmill dose delivered was too low to know if effective.
Key findings
01No outcome favoured treadmill training over usual physiotherapy at eight weeks or six months.
02The treadmill group received only the minimum two sessions per week, with median treadmill time of 8 to 16 minutes per week at a median speed of 0.6 m/s.
03Two adverse events occurred during treadmill training, and no adverse events were reported for control participants.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 77 participants were recruited, and no formal power calculation was done, so the trial cannot show whether treadmill training works or does not work. The treadmill dose was low: median 8 to 16 minutes per week at a median speed of 0.6 m/s, so this was not a test of a potentially effective intensive programme. Participants and therapists were not blinded to allocation, although outcome assessors were blinded. Analysis used only completed outcome measures, and timed walking tests had high missing data because many participants could not walk or stand independently at baseline. No adjustment was made for baseline imbalance or the variables used in randomization. The intervention was shaped by local NHS staffing resources, so results may not apply where therapists can deliver more treadmill time. Recruitment was low: only 15% of 526 people assessed were recruited.
Declared interests
The authors declared no potential conflicts of interest. The study was funded by a Chest, Heart, Stroke Scotland grant.
The easy way to misread this
Do not conclude treadmill training is ineffective. The study was not powered to detect differences, and the median treadmill time was 8 to 16 minutes per week, which is too low to test the intervention properly.