Treadmill walking with body weight support in subacute non-ambulatory stroke improves walking capacity more than overground walking: a randomised trial. Very Early Mobilization After Stroke Fast-Tracks Return to Walking: Further Results From the Phase II AVERT Randomized Controlled Trial Randomized Trial of Treadmill Walking With Body Weight Support to Establish Walking in Subacute Stroke: The MOBILISE Trial Does therapeutic facilitation add to locomotor outcome of body weight--supported treadmill training in nonambulatory patients with stroke? A randomized controlled trial. Supported treadmill training to establish walking in non-ambulatory patients early after stroke Walking training of patients with hemiparesis at an early stage after stroke: a comparison of walking training on a treadmill with body weight support and walking training on the ground Body weight supported treadmill training versus traditional training in patients dependent on walking assistance after stroke: a randomized controlled trial Effects of Task-Specific and Impairment-Based Training Compared With Usual Care on Functional Walking Ability After Inpatient Stroke Rehabilitation Assistive walking devices in nonambulant patients undergoing rehabilitation after stroke: the effects on functional mobility, walking impairments, and patients' opinion. Body-weight-supported treadmill rehabilitation after stroke. Enhanced Gait-Related Improvements After Therapist- Versus Robotic-Assisted Locomotor Training in Subjects With Chronic Stroke: A Randomized Controlled Study Who May Have Durable Benefit From Robotic Gait Training?: A 2-Year Follow-Up Randomized Controlled Trial in Patients With Subacute Stroke Effects of Task-Specific Locomotor and Strength Training in Adults Who Were Ambulatory After Stroke: Results of the STEPS Randomized Clinical Trial Effects of transcranial direct current stimulation over the supplementary motor area body weight-supported treadmill gait training in hemiparetic patients after stroke Gait outcomes after acute stroke rehabilitation with supported treadmill ambulation training: a randomized controlled pilot study. Who May Benefit From Robotic-Assisted Gait Training? Can augmented physiotherapy input enhance recovery of mobility after stroke? A randomized controlled trial
QUESTIONS Is treadmill walking with body weight support during inpatient rehabilitation detrimental to walking quality compared with assisted overground walking ? Does it result in better walking capacity , perception of walking or community participation ? DESIGN Analysis of secondary outcomes of a r and omised trial with concealed allocation , assessor blinding and intention-to-treat analysis . PARTICIPANTS 126 patients unable to walk within 4 weeks of a stroke who were undergoing inpatient rehabilitation . INTERVENTION The experimental group undertook up to 30 minutes of treadmill walking with body weight support via an overhead harness per day while the control group undertook up to 30 minutes of overground walking . OUTCOME MEASURES The secondary outcomes were walking quality and capacity , walking perception , community participation and falls . RESULTS Six months after entering the study , there was no difference between the groups of independent walkers in terms of speed ( MD 0.10 m/s , 95 % CI -0.06 to 0.26 ) or stride ( MD 6 cm , 95 % CI -7 to 19 ) . The independent walkers in the experimental group walked 57 m further ( 95 % CI 1 to 113 ) in the 6 min walk than those in the control group . The experimental group ( walkers and non-walkers ) rated their walking 1 point out of 10 ( 95 % CI 0.1 to 1.9 ) higher than the control group . There was no difference between the groups in community participation or number of falls . CONCLUSION Treadmill training with body weight support results in better walking capacity and perception of walking compared to overground walking without deleterious effects on walking quality Background and Purpose — Regaining functional independence is an important goal for people who have experienced stroke . We hypothesized that introducing earlier and more intensive out-of-bed activity after stroke would reduce time to unassisted walking and improve independence in activities of daily living . Methods — A Very Early Rehabilitation Trial ( AVERT ) was a phase II r and omized controlled trial . Patients with confirmed stroke ( infa rct or hemorrhage ) admitted < 24 hours after stroke and who met physiological safety criteria were eligible . Patients r and omized to the very early and intensive mobilization group were mobilized within 24 hours of stroke and at regular intervals thereafter .  Control patients received st and ard stroke unit care . The primary outcome for this analysis was the number of days required to return to walking 50 m unassisted . Secondary outcomes were the Barthel Index and Rivermead Motor Assessment at 3 and 12 months after stroke . Results — Seventy-one stroke patients with a mean age of 74.7 years were recruited from 2 hospitals . Adjusted Cox regression indicated that very early and intensive mobilization group patients returned to walking significantly faster than did st and ard stroke unit care controls ( P=0.032 ; median 3.5 vs 7.0 days ) . Multivariable regression revealed that exposure to very early and intensive mobilization was independently associated with good functional outcome on the Barthel Index at 3 months ( P=0.008 ) and on the Rivermead Motor Assessment at 3 ( P=0.050 ) and 12 ( P=0.024 ) months . Conclusions — Earlier and more intensive mobilization after stroke may fast-track return to unassisted walking and improve functional recovery . Clinical Trial Registration — This trial was not registered because enrollment began before July 2005 Background and Purpose — The main objective of this r and omized trial was to determine whether treadmill walking with body weight support was effective at establishing independent walking more often and earlier than current physiotherapy intervention for nonambulatory stroke patients . Methods — A r and omized trial with concealed allocation , blinded assessment , and intention-to-treat analysis was conducted . One hundred twenty-six stroke patients who were unable to walk were recruited and r and omly allocated to an experimental or a control group within 4 weeks of stroke . The experimental group undertook up to 30 minutes per day of treadmill walking with body weight support via an overhead harness whereas the control group undertook up to 30 minutes of overground walking . The primary outcome was the proportion of participants achieving independent walking within 6 months . Results — Kaplan – Meier estimates of the proportion of experimental participants who achieved independent walking were 37 % compared with 26 % of the control group at 1 month , 66 % compared with 55 % at 2 months , and 71 % compared with 60 % at 6 months ( P=0.13 ) . The experimental group walked 2 weeks earlier , with a median time to independent walking of 5 weeks compared to 7 weeks for the control group . In addition , 14 % ( 95 % CI , −1–28 ) more of the experimental group were discharged home . Conclusions — Treadmill walking with body weight support is feasible , safe , and tends to result in more people walking independently and earlier after stroke . Trial Registration — NN Clinical Trial.gov ( NCT00167531 ) OBJECTIVE To assess benefit of the facilitation technique ( FT ) coupled with body weight-supported treadmill training ( BWSTT ) in nonambulatory patients with stroke . DESIGN R and omized controlled trial . SETTING Inpatient rehabilitation hospital . PARTICIPANTS Forty-nine patients with nonambulatory patients with stroke were r and omly allocated to BWSTT coupled with the FT or mechanical assistance ( control ) . INTERVENTIONS Swinging and stance of the paretic leg were assisted using the FT or mechanically ( control ) during BWSTT . MAIN OUTCOME MEASURES The FIM instrument , Fugl-Meyer Assessment , gait speed , and cadence . RESULTS Demographic and clinical features of the  FT ( n=22 ) and control ( n=25 ) groups on admission were comparable after excluding 2 dropouts . There were no differences in the gains of the main outcome measures between the FT and control groups . Patients with severe impairment in the FT group had greater gains in arm function than those in the control group . CONCLUSIONS The FT did not add significantly to locomotor outcome of BWSTT in nonambulatory patients with stroke but it did require more therapists ' assistance Background It has been reported that only half of the non-ambulatory stroke patients admitted to inpatient rehabilitation in Australia learn to walk again [ 1 ] . Treadmill walking with partial weight support via an overhead harness is a relatively new intervention that is design ed to train walking . The main objective of this r and omised controlled trail is to determine whether treadmill walking with partial weight support via an overhead harness is effective at establishing independent walking ( i ) more often , ( ii ) earlier and ( iii ) with a better quality of walking , than current physiotherapy intervention for non-ambulatory stroke patients . Methods A prospect i ve , r and omised controlled trial of inpatient intervention with a 6 month follow-up with blinded assessment will be conducted . 130 stroke patients who are unable to walk independently early after stroke will be recruited and r and omly allocated to a control group or an experimental group . The control group will undertake 30 min of routine assisted overground walking while the experimental group will undertake 30 min of treadmill walking with partial weight support via an overhead harness per day . The proportion of participants achieving independent walking , the quality of walking , and community participation will be measured . The study has obtained ethical approval from the Human Research Ethics Committees of each of the sites involved in the study . Discussion Given that the Australian population is ageing and people after stroke can expect to live for longer , attainment of safe , independent walking is more likely to be associated with long-term health and well being . In its National Research Priorities , the Government has recognised that it will be important to promote healthy ageing and that this endeavour will be underpinned by research . The results of this study will clearly identify effective intervention to establish early quality walking , thereby promoting an increase in community participation in the longer term . Trial Registration The protocol for this study is registered with US NIH Clinical trials registry ( NCT00167531 Objective : To compare the effect of walking training on a treadmill with body weight support ( BWS ) and walking training on the ground at an early stage of rehabilitation in patients with hemiparesis after stroke . Design : R and omized controlled experimental study . Setting : Multicentre design ; three departments of rehabilitation medicine . Subjects : Seventy-three consecutive first stroke patients admitted to a rehabilitation clinic were r and omized into a treatment group and a control group . Interventions : The treatment group received walking training on a treadmill with BWS for 30 minutes , 5 days a week . The control group received walking training according to the Motor Relearning Programme ( MRP ) on the ground for 30 minutes 5 days a week , not including treadmill training . During the time in the rehabilitation department ( about two months ) , all patients in the study also received professional stroke rehabilitation besides the walking training in the two groups . Main outcome measures : Functional Independence Measure ( FIM ) , walking velocity for 10 m , Functional Ambulation Classification ( FAC ) , Fugl-Meyer Stroke Assessment and Berg 's Balance Scale . The assessment s were performed at admission , at discharge and at 10-month follow-up . Results : There were no statistically significant differences between the groups at discharge or at the 10-month follow-up with regard to FIM , walking velocity , FAC , Fugl-Meyer Stroke Assessment , and Berg 's Balance Scale . Patients in both groups improved in these variables from admission to the 10-month follow-up . Conclusions : Treadmill training with BWS at an early stage of rehabilitation after stroke is a comparable choice to walking training on the ground Purpose : Treadmill training with body weight support ( TTBWS ) for relearning walking ability after brain damage is an approach under current investigation . Efficiency of this method beyond traditional training is lacking evidence , especially in patients needing walking assistance after stroke . The objective of this study was to investigate change in walking and transfer abilities , comparing TTBWS with traditional walking training . Methods : A single-blinded , r and omized controlled trial was conducted . Sixty patients referred for multi-disciplinary primary rehabilitation were assigned into one of two intervention groups , one received 30 sessions of TTBWS plus traditional training , the other traditional training alone . Daily training was 1 hr . Outcome measures were Functional Ambulation Categories ( FAC ) , Walking , Functional Independence Measure ( FIM ) ; shorter transfer and stairs , 10 m and 6-min walk tests . Results : Substantial improvements in walking and transfer were shown within both groups after 5 and 11 weeks of intervention . Overall no statistical significant differences were found between the groups , but 12 of 17 physical measures tended to show improvements in favour of the treadmill approach . Conclusions : Both training strategies provided significant improvements in the tested activities , suggesting that similar outcomes can be obtained in the two modalities by systematic , intensive and goal directed training . Implication s for Rehabilitation Treadmill training with body weight support ( TTBWS ) and traditional gait training were found to be equally effective in improving walking and transfer in patients dependent on walking assistance after stroke . However , most outcome measures showed a tendency of improvement in favour of the treadmill group . Both training modalities were systematic , goal -directed and intensive , and the time used for training was the same . The choice between the two equally effective training alternatives should be based on the patients ’ preference , and availability of equipment and re sources Background . After inpatient stroke rehabilitation , many people still can not participate in community activities because of limited walking ability . Objective . To compare the effectiveness of 2 conceptually different , early physical therapy ( PT ) interventions to usual care ( UC ) in improving walking 6 months after stroke . Methods . The Locomotor Experience Applied Post-Stroke ( LEAPS ) study was a single-blind , r and omized controlled trial conducted in 408 adults with disabling hemiparetic stroke . Participants were stratified at baseline ( 2 months ) by impairment in walking speed : severe ( < 0.4 m/s ) or moderate ( 0.4 to < 0.8 m/s ) . Between 2 and 6 months , they received either only UC ( n = 143 ) or UC plus 36 therapist-provided sessions of either ( 1 ) walking training on a treadmill using body-weight support and practice overground at clinics ( locomotor training program [ LTP ] , n = 139 ) or ( 2 ) impairment-based strength and balance exercise at home ( home exercise program [ HEP ] , n = 126 ) . Results . LTP participants were 18 % more likely to transition to a higher functional walking level : severe to > 0.4 m/s and moderate to > 0.8 m/s than UC participants ( 95 % confidence interval [ CI ] = 7%-29 % ) , and HEP participants were 17 % more likely to transition ( 95 % CI = 5%-29 % ) . Mean gain in walking speed in LTP participants was 0.13 m/s greater ( 95 % CI = 0.09 - 0.18 ) and in HEP participants , 0.10 m/s greater ( 95 % CI = 0.05 - 0.14 ) than in UC participants . Conclusions . Progressive PT , using either walking training on a treadmill and overground , conducted in a clinic , or strength and balance exercises conducted at home , was superior to UC in improving walking , regardless of severity of initial impairment OBJECTIVE To assess the immediate effects of assistive walking devices on functional mobility , walking impairments , and patients ' opinions in nonambulant patients after stroke . DESIGN R and omized crossover trial . SETTING Inpatient rehabilitation units of 3 United Kingdom hospitals . PARTICIPANTS Twenty nonambulant patients with stroke undergoing rehabilitation to restore walking . INTERVENTIONS Five walking conditions : ( 1 ) Walking with no device ( the control condition ) , ( 2 ) walking with a walking cane , ( 3 ) ankle foot orthosis , ( 4 ) slider shoe , and ( 5 ) a combination of all 3 devices . MAIN OUTCOME MEASURES Functional mobility ( functional ambulation categories ) , walking impairments ( speed , step length of the weak leg ) , and patients ' opinions . RESULTS Functional mobility improved with all assistive devices ( P<.0001-.005 ; effect sizes 1.68 - 0.52 ; number needed to treat=2 - 5 ) . Walking impairments were unchanged ( P<.800-.988 ) . Participants were generally positive about the devices . They felt their walking , confidence , and safety improved and found the appearance and comfort of the devices acceptable . They would rather walk with the devices than delay walking until a normative gait pattern was achieved without them . CONCLUSIONS Assistive walking devices improved functional mobility in nonambulant rehabilitation patients with stroke . No changes in walking impairments were found . Participants were generally positive about using the devices . The results support the use of assistive walking devices to enable early mobilization after stroke ; 2 patients would need to be treated with a cane or combined devices for 1 to improve functional mobility BACKGROUND Locomotor training , including the use of body-weight support in treadmill stepping , is a physical therapy intervention used to improve recovery of the ability to walk after stroke . The effectiveness and appropriate timing of this intervention have not been established . METHODS We stratified 408 participants who had had a stroke 2 months earlier according to the extent of walking impairment -- moderate ( able to walk 0.4 to < 0.8 m per second ) or severe ( able to walk < 0.4 m per second)-- and r and omly assigned them to one of three training groups . One group received training on a treadmill with the use of body-weight support 2 months after the stroke had occurred ( early locomotor training ) , the second group received this training 6 months after the stroke had occurred ( late locomotor training ) , and the third group participated in an exercise program at home managed by a physical therapist 2 months after the stroke ( home-exercise program ) . Each intervention included 36 sessions of 90 minutes each for 12 to 16 weeks . The primary outcome was the proportion of participants in each group who had an improvement in functional walking ability 1 year after the stroke . RESULTS At 1 year , 52.0 % of all participants had increased functional walking ability . No significant differences in improvement were found between early locomotor training and home exercise ( adjusted odds ratio for the primary outcome , 0.83 ; 95 % confidence interval [ CI ] , 0.50 to 1.39 ) or between late locomotor training and home exercise ( adjusted odds ratio , 1.19 ; 95 % CI , 0.72 to 1.99 ) . All groups had similar improvements in walking speed , motor recovery , balance , functional status , and quality of life . Neither the delay in initiating the late locomotor training  nor the severity of the initial impairment affected the outcome at 1 year . Ten related serious adverse events were reported ( occurring in 2.2 % of participants undergoing early locomotor training , 3.5 % of those undergoing late locomotor training , and 1.6 % of those engaging in home exercise ) . As compared with the home-exercise group , each of the groups receiving locomotor training had a higher frequency of dizziness or faintness during treatment ( P=0.008 ) . Among patients with severe walking impairment , multiple falls were more common in the group receiving early locomotor training than in the other two groups ( P=0.02 ) . CONCLUSIONS Locomotor training , including the use of body-weight support in stepping on a treadmill , was not shown to be superior to progressive exercise at home managed by a physical therapist . ( Funded by the National Institute of Neurological Disorders and Stroke and the National Center for Medical Rehabilitation Research ; LEAPS Clinical Trials.gov number , NCT00243919 . ) Background and Purpose — Locomotor training ( LT ) using a treadmill can improve walking ability over conventional rehabilitation in individuals with hemiparesis , although the personnel requirements often necessary to provide LT may limit its application . Robotic devices that provide consistent symmetrical assistance have been developed to facilitate LT , although their effectiveness in improving locomotor ability has not been well established . Methods — Forty-eight ambulatory chronic stroke survivors stratified by severity of locomotor deficits completed a r and omized controlled study on the effects of robotic- versus therapist-assisted LT . Both groups received 12 LT sessions for 30 minutes at similar speeds , with guided symmetrical locomotor assistance using a robotic orthosis versus manual facilitation from a single therapist using an assist-as-needed paradigm . Outcome measures included gait speed and symmetry , and clinical measures of activity and participation . Results — Greater improvements in speed and single limb stance time on the impaired leg were observed in subjects who received therapist-assisted LT , with larger speed improvements in those with less severe gait deficits . Perceived rating of the effects of physical limitations on quality of life improved only in subjects with severe gait deficits who received therapist-assisted LT . Conclusions — Therapist-assisted LT facilitates greater improvements in walking ability in ambulatory stroke survivors as compared to a similar dosage of robotic-assisted LT Background and Purpose — Robotic-assisted walking training after stroke aims to enhance the odd of regaining independent gait . Recent studies have suggested that this approach is more effective than conventional therapy alone only in severely affected patients . We determined whether these results persist at long-term follow-up . Methods — Forty-eight nonambulant participants after subacute stroke were stratified by motricity index into high ( < 29 ) and low ( ≥29 ) motor impairment groups . Each arm was r and omized to a robotic or control group at a mean of 20 days after stroke . All patients underwent 2 therapy sessions per day , 5 days per week , for 3 months . Robotic group subjects underwent 20 sessions of robotic-assisted gait training in the first 4 weeks of inpatient therapy and abbreviated conventional therapy , whereas control group patients received only conventional gait training . The primary outcome was Functional Ambulation Category , and secondary measures were the Rivermead Mobility Index and Barthel Index scores . The scales were administered before and after the inpatient stay and 2 years after discharge . Results — At follow-up , as at discharge , the low motricity robotic group improved more than the control group counterpart with regard to functional ambulation category ( 4.7±0.5 versus 3.1±1.5 , P=0.002 ) , Barthel Index ( 76.9±11.5 versus 64.7±14.0 , P=0.024 ) , and Rivermead Mobility Index ( 11.8±3.5 versus 7.0±3.6 , P=0.010 ) , whereas conventional and robotic therapies were equally effective in the high motricity groups . Conclusions — The higher efficacy of the combination of robotic therapy and conventional therapy versus conventional therapy alone that was observed at discharge only in patients with greater motor impairments was sustained after 2 years Background and Purpose : A phase II , single-blinded , r and omized clinical trial was conducted to determine the effects of combined task-specific and lower-extremity ( LE ) strength training to improve walking ability after stroke . Subjects : The participants were 80 adults who were ambulatory 4 months to 5 years after a unilateral stroke . Method : The exercise interventions consisted of body-weight – supported treadmill training ( BWSTT ) , limb-loaded resistive leg cycling ( CYCLE ) , LE muscle-specific progressive-resistive exercise ( LE-EX ) , and upper-extremity ergometry ( UE-EX ) . After baseline assessment s , participants were r and omly assigned to a combined exercise program that included an exercise pair . The exercise pairs were : BWSTT/UE-EX , CYCLE/UE-EX , BWSTT/CYCLE , and BWSTT/LE-EX . Exercise sessions were 4 times per week for 6 weeks ( total of 24 sessions ) , with exercise type completed on alternate days . Outcomes were self-selected walking speed , fast walking speed , and 6-minute walk distance measured before and after intervention and at a 6-month follow-up . Results : The BWSTT/UE-EX group had significantly greater walking speed increases compared with the CYCLE/UE-EX group ; both groups improved in distance walked . All BWSTT groups increased walking speed and distance whether BWSTT was combined with LE strength training or not . Discussion and Conclusion : After chronic stroke , task-specific training during treadmill walking with body-weight support is more effective in improving walking speed and maintaining these gains at 6 months than resisted leg cycling alone . Consistent with the overtraining literature , LE strength training alternated daily with BWSTT walking did not provide an added benefit to walking outcomes Transcranial direct current stimulation ( tDCS ) is used in a variety of disorders after stroke including upper limb motor dysfunctions , hemispatial neglect , aphasia , and apraxia , and its effectiveness has been demonstrated . Although gait ability is important for daily living , there were few reports of the use of tDCS to improve balance and gait ability . The supplementary motor area ( SMA ) was reported to play a potentially important role in balance recovery after stroke . We aim ed to investigate the effect of combined therapy body weight-supported treadmill training ( BWSTT ) and tDCS on gait function recovery of stroke patients . Thirty stroke in patients participated in this study . The two BWSTT periods of 1weeks each , with real tDCS ( anode : front of Cz , cathode : inion , 1mA , 20min ) on SMA and sham stimulation , were r and omized in a double-blind crossover design . We measured the time required for the 10 m Walk Test ( 10MWT ) and Timed Up and Go ( TUG ) test before and after each period . We found that the real tDCS with BWSTT significantly improved gait speed ( 10MWT ) and applicative walking ability ( TUG ) , compared with BWSTT+sham stimulation periods ( p<0.05 ) . Our findings demonstrated the feasibility and efficacy of tDCS in gait training after stroke . The facilitative effects of tDCS on SMA possibly improved postural control during BWSTT . The results indicated the implication s for the use of tDCS in balance and gait training rehabilitation after stroke OBJECTIVE To investigate gait outcomes with supported treadmill ambulation training ( STAT ) associated with regular rehabilitation in acute stroke survivors . DESIGN R and omized controlled trial , pilot study . SETTING Rehabilitation medicine service at a Veterans Affairs medical center . PARTICIPANTS Seven acute stroke survivors assigned to regular intervention group and 6 patients assigned to STAT intervention .  INTERVENTIONS Regular intervention consisted of 3 hours daily of physical therapy , kinesiotherapy , and occupational therapy . STAT group received regular rehabilitation with STAT substituted for usual gait training . Participants were tested at baseline , treated for an average of 3 weeks , and retested on discharge . The analysis of covariance procedure was used to test for differences between the 2 approaches . MAIN OUTCOME MEASURES Functional Ambulation Category Scale , gait speed , walking distance , gait energy expenditure , and gait energy cost . RESULTS The small sample size did not generate enough power to detect significant differences in any variable . However , medium to large effect sizes of 0.7 and 1.16 st and ard deviation units were observed for gait energy cost and walk distance , respectively . CONCLUSIONS This pilot study indicated that STAT is a safe , feasible , and promising intervention for acute stroke survivors . A larger trial is warranted for statistical relevance Background . Robotic-assisted walking training after stroke aims to enable highly impaired patients to walk independently , but results have been mixed . Objective . The authors aim ed to identify the characteristics of patients who may be most likely to benefit . Methods . A total of 48 participants with motor and gait dysfunction following subacute stroke were stratified by the motricity index into high ( < 29 ) and low ( ≥29 ) motor impairment groups . Each arm was r and omized to a robotic or control group ( RG or CG ) at a mean of 20 days after stroke . All patients underwent 2 therapy sessions per day , 5 days per week for 3 months . Those in the RG underwent 20 sessions of robotic-assisted gait training in the first 4 weeks of inpatient therapy using controlled endpoint trajectories and abbreviated conventional therapy , whereas the CG received only conventional gait training . The primary outcome was the functional ambulation category ( FAC ) , and secondary measures were the Rivermead mobility index ( RMI ) and 6-minute walking distance , all evaluated at hospital admission and at discharge . Results . The lower motricity group assigned to an electromechanical device significantly improved in the FAC ( P < .001 ) , RMI ( P = .001 ) , and walking distance ( P = .029 ) . Conventional and robotic therapies were equivalent in the higher motricity arm . Conclusion . Robotic therapy combined with conventional therapy may be more effective than conventional therapy alone in patients with greater motor impairment during inpatient stroke rehabilitation Objective : To discover if the provision of additional  inpatient physiotherapy after stroke speeds the recovery of mobility . Design : A multisite single-blind r and omized controlled trial ( RCT ) comparing the effects of augmented physiotherapy input with normal input on the recovery of mobility after stroke . Setting : Three rehabilitation hospitals in North Glasgow , Scotl and . Subjects : Patients admitted to hospital with a clinical diagnosis of stroke , who were able to tolerate and benefit from mobility rehabilitation .  Intervention : We aim ed to provide double the amount of physiotherapy to the augmented group . Main measures : Primary outcomes were mobility milestones ( ability to st and , step and walk ) , Rivermead Mobility Index ( RMI ) and walking speed . Results : Seventy patients were recruited . The augmented therapy group received more direct contact with a physiotherapist ( 62 versus 35 minutes per weekday ) and were more active ( 8.0 % versus 4.8 % time st and ing or walking ) than normal therapy controls . The augmented group tended to achieve independent walking earlier ( hazard ratio 1.48 , 95 % confidence interval 0.90–2.43 ; p=0.12 ) and had higher Rivermead Mobility Index scores at three months ( mean difference 1.6 ; 0.1 to 3.3 ; p=0.068 ) but these differences did not reach statistical significance . There was no significant difference in any other outcome . Conclusions : A modest augmented physiotherapy programme result ed in patients having more direct physiotherapy time and being more active . The inability to show statistically significant changes in outcome measures could indicate either that this intervention is ineffective or that our study could not detect modest changes
Mechanically assisted walking with body weight support is more effective than overground walking at increasing independent walking in non-ambulatory patients early after stroke .
QUESTION Does mechanically assisted walking with body weight support result in more independent walking and is it detrimental to walking speed or capacity in non-ambulatory patients early after stroke ?