Exercise training improves walking function in an African group of stroke survivors: a randomized controlled trial

Objective: To evaluate the effects of treadmill walking and overground walking exercise training on recovery of walking function in an African group of stroke survivors. Design: Prospective, randomized controlled study. Setting: Outpatient stroke rehabilitation unit in a tertiary hospital. Subjects: Sixty patients with chronic stroke (>= 3 months). Intervention: All subjects received individual outpatient conventional physiotherapy rehabilitation for 12 weeks. In addition, subjects in Group A (n = 20) received treadmill walking exercise training (TWET) while those in Group B (n = 20) received overground walking exercise training (OWET). Those in Group C (control) (n = 20) received conventional physiotherapy rehabilitation only. Main measures: Outcome measures were (i) 10-metre walk time (10MWT) test and (ii) six-minute walk distance (6MWD) test. These were evaluated at entry into the study and at the end of every four weeks. Paired t-tests were used to evaluate the significance of the difference between pre-training and post-training scores on the two measures (P < 0.05). Results: Subjects in the TWET group recorded 22.6 +/- 1.5% decrease in 10MWT and 31.0 +/- 4.3% increase in 6MWD; those in the OWET group made 26.8 +/- 1.3% and 45.2 +/- 4.6% improvement in 10MWT and 6MWD respectively. Subjects in the control group made 2.2 +/- 0.7% and 2.9 +/- 0.8% improvement in the two functions. These changes were significant for the TWET and OWET groups (P < 0.05). Conclusion: This study indicated that treadmill and overground walking exercise training programmes, combined with conventional rehabilitation, improved walking function in an African group of adult stroke survivors. Therefore, professionals who conduct stroke rehabilitation programmes should utilize exercise training to optimize patient outcomes.