Does treadmill training affect activities of daily living or quality of life after stroke? Results of a phase II randomised controlled trial.

Abstract

Introduction: A Cochrane review, evaluating treadmill training (TT) after stroke, found current evidence to be inconclusive and highlighted the need for further well-designed large-scale trials. It was noted that insufficient data existed to undertake analysis of outcomes related to activities of daily living (ADLs) and quality of life (QoL) and the inclusion of these outcome measures in future research was recommended. As part of a recently completed trial evaluating the impact of TT after stroke, outcomes were collected to evaluate the impact on ADLs and QoL. Method: A phase II randomised controlled trial was undertaken across four hospitals in Lothian. Participants were randomised to either a control group, who continued to receive 'usual' physiotherapy sessions, or an experimental group that received TT as part of 'usual' physiotherapy sessions. The intervention period lasted for 8 weeks. The Barthel Index and Stroke Impact Scale were collected at baseline, and at 8 weeks and 6 months post randomisation. Results: Seventy-seven participants were recruited. Thirty-eight were randomised into the control group and thirty-nine into the TT group. Statistical analysis using a Kruskal-Wallis test found no statistically significant differences between the control and TT group at baseline, at 8 weeks or at 6 months post randomisation on the Barthel Index or Stroke Impact Scale. Conclusion: ADL and QoL scores improved after stroke in both the control and TT group, but neither approach was superior. Power calculations indicate that a larger trial is required to confirm these results.