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Stroke Rehab: Home Exercise as Good as Rehab Facility

Study Shows Walking Improves for Stroke Patients Who Get Physical Therapy at Home

Treadmill Training vs. Home Exercise continued...

In the treadmill training sessions, patients were strapped into a harness that partially supported their body weight. A physical therapist helped them move their weakened leg as they walked for 20 to 30 minutes on a treadmill. They followed that with practicing walking on the ground for another 15 minutes. The rest of the session was used for warm-up and stretching exercises.

In the home exercise sessions, a physical therapist worked with participants to improve balance, strength, and flexibility. Sessions became progressively more challenging. Home exercisers were encouraged to walk daily, but walking was not part of their structured training.

By one year after their strokes, 52% of participants had improved by one functional level, meaning that if they walked more slowly than about 1 mile per hour before the study, they were able to walk at least as fast as a mile per hour after their exercise training. If they walked between about 1 and 2 miles per hour before the study, they were able to walk at least as briskly as 2 miles per hour afterward.

Those are significant improvements, Linder says.

"If you looked at what typical walking speed is for an older adult, it really is around 2 miles per hour or faster, so that's really achieving what age norms would be," Linder says.

At walking speeds less than a mile an hour, Linder says, it's hard to do basic thinks like cross a street before traffic lights change.

All groups also had similar improvements in motor recovery, balance, functional status, and quality of life.

There were slightly more falls and adverse events in the treadmill exercisers, though the rates were low across all groups.

One major difference between groups was the retention rate.

There were fewer dropouts in the home-based program; just 3% in that group stopped their exercise, compared to 13% in the early treadmill training group and 17% in late treadmill training arm.

"It is highly encouraging that they're more compliant, more adherent," says Libman. "Lots of people would go home if they could choose to."

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