Does Therapeutic Facilitation Add to Locomotor Outcome of Body Weight−Supported Treadmill Training in Nonambulatory Patients With Stroke? A Randomized Controlled Trial

Abstract 

Yagura H, Hatakenaka M, Miyai I. 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 FIM 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.

Key Words:  Gait , Hemiplegia , Rehabilitation , Stroke , Treadmill test , Weight-bearing