Does therapeutic facilitation add to locomotor outcome of body weight-supported treadmill training in nonambulatory patients with stroke? A randomized controlled trial

Objective: To assess benefit of the facilitation technique (FT) coupled with body weight-supported treadmill training (BWSTT) in nonambulatory patients with stroke. Design: Randomized controlled trial. Setting: Inpatient rehabilitation hospital. Participants: Forty-nine patients with nonambulatory patients with stroke were randomly 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 FT 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.