Gait training strategies to optimize walking ability in people with stroke: a synthesis of the evidence

Abstract

Stroke is a leading cause of long-term disability. Impairments resulting from stroke lead to persistent difficulties with walking and, subsequently, improved walking ability is one of the highest priorities for people living with a stroke. In addition, walking ability has important health implications in providing protective effects against secondary complications common after a stroke such as heart disease or osteoporosis. This paper systematically reviews common gait training strategies (neurodevelopmental techniques, muscle strengthening, treadmill training and intensive mobility exercises) to improve walking ability. The results (descriptive summaries as well as pooled effect sizes) from randomized controlled trials are presented and implications for optimal gait training strategies are discussed. Novel and emerging gait training strategies are highlighted and research directions proposed to enable the optimal recovery and maintenance of walking ability.

Keywords::

• cerebrovascular disease
• exercise
• gait
• meta-analysis
• mobility
• rehabilitation
• review
• stroke
• systematic
• treadmill
• walking

Financial & competing interests disclosure

We would like to acknowledge career scientist awards (Janice J Eng) from the Canadian Institutes of Health Research and the Michael Smith Foundation for Health Research and grant no. NHRI-EX96–9210EC (Pei-Fang Tang) from the National Health Research Institutes, Taiwan, ROC.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.