Stroke Rehab: Home Exercise as Good as Rehab Facility
Study Shows Walking Improves for Stroke Patients Who Get Physical Therapy at Home
Effects of a Stroke continued...
"This was, to my knowledge, the first large-scale, rigorously done trial showing that patients could make just as much progress, in terms of walking, with intensive home physical therapy as with the much more expensive inpatient rehab using treadmills and other complex equipment than are available at home," says Richard B. Libman, MD, chief of the division of vascular neurology at Long Island Jewish Medical Center, in New Hyde Park, N.Y.
Other experts, however, said they were surprised and unconvinced by the results.
"To see that, in this study, that the body weight support wasn't superior to home exercises was a little bit surprising," says Susan Linder, a research physical therapist with the Cleveland Clinic in Ohio. "Because everything that we have thought really indicates that patients really learn better not just on the treadmill, but with this body weight support."
Linder says the results of the study are clouded by the fact that more than 80% of study participants in all groups also received additional physical therapy, usually in outpatient facilities, on top of the gait training work they were assigned for the study.
"What isn't controlled for is what physical therapy interventions they were receiving outside of the study," Linder tells WebMD.
Treadmill Training vs. Home Exercise
For the study, patients over age 18 with one weakened leg after a recent stroke were recruited from six rehabilitation facilities in California and Florida.
To be included, they had to be able to walk at least 10 feet with minimal help and to tolerate exercise. They also had to be living at home or were expected to return home after therapy.
Four hundred eight patients qualified for the study. The average age of study participants was 62.
Two months after their strokes, they were randomly assigned to one of three groups: early treadmill training, later treadmill training, or home exercise.
All participants received 30 to 36 sessions of physical therapy for 90 minutes, three days per week. The early treadmill training group and home exercise group started their regimens two months after their strokes. The late treadmill training group began six months after their strokes.