Inclined treadmill training (ITT) for people with chronic stroke - a systematic review and meta-analysis

Abstract

Background

Considering the alterations in gait patterns and increase in metabolic demands during walking on an inclined surface, inclined treadmill training (ITT) may be an alternative treatment to non-inclined treadmill training (NITT) for improving gait and balance among people with chronic stroke.

Design

We searched eight electronic databases (August 2021), assessed risk of bias (Cochrane RoB 2.0 tool), and meta-analysed data (RevMan 3.5). Results were reported according to the PRISMA guidelines. Outcomes were gait parameters such as walking speed and balance-related outcome measures such as Berg Balance Scale scores. Risk of bias assessment was performed according to Version 2 of the Cochrane risk-of-bias tool for randomised trials (RoB 2).

Results

Of the screened citations, four met our inclusion criteria. Quantitative analysis showed ITT was significant in improving walking speed, stride length, paretic step length, Berg Balance Scale scores and Overall Stability Index (p < 0.05) but not in cadence, non-paretic step length, stance time on the non-paretic and paretic leg (p > 0.05). Only one study was rated low risk of bias.

Conclusion

There was limited evidence for the superiority of ITT over NITT, in adjunct to other conventional intervention, for improving gait and balance among chronic stroke patients.

Keywords:

• Stroke
• treadmill training
• inclined
• balance
• gait

Acknowledgement

The authors acknowledge Dr. Ruth Barclay, Olayinka Akinrolie and Chun Kit Isaac Fong for their valuable suggestions during planning of this research work, to Dr. Nuray Alaca for providing information regarding her study, and also to Christine Neilson (Health Sciences Library, University of Manitoba) for peer review of the MEDLINE search strategy.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study received no funding.