CHICAGO (Reuters) - Stroke patients who get intensive physical therapy at home walk just as well after a year as patients who train on fancy, high-tech treadmills that support their weight, U.S. researchers said on Friday.
And patients who start physical therapy even six months after a stroke or other injury can still improve their walking ability, contradicting previous assumptions that such improvement is limited to the first half year, they said.
The surprise findings, released on Friday at the American Stroke Association’s International Stroke Conference in Los Angeles, come from the biggest stroke rehabilitation study ever conducted in the United States.
“The results of this study show that the more expensive, high-tech therapy was not superior to intensive home strength and balance training, but both were better than lower intensity physical therapy,” said Dr. Walter Koroshetz of the National Institute of Health’s National Institute of Neurological Disorders and Stroke, whose agency funded the study.
The study expands treatment options for stroke patients, and suggests that patients who do not start physical therapy within the first six months of their injury can still make gains in their ability to walk.
“The conventional wisdom is not true,” Katherine Sullivan of the University of Southern California, who helped lead the study, said in a statement.
“The potential for recovery is well beyond the first few months after an injury or after a stroke,” Sullivan said.
The study, dubbed the Locomotor Experience Applied Post-Stroke or LEAPS, set out to determine the best treatments for the more than 4 million U.S. stroke survivors who have trouble walking, raising their risk of falls, bone fractures and declining health.
It involved more than 400 patients with either severe or moderate walking impairments who were randomly assigned into three study groups.
Researchers studied the effectiveness of locomotor training, an increasingly popular treatment that involves having a patient walk on a treadmill in a harness that provides partial body weight support. After the treadmill training, patients practice walking.
In the study, the team evaluated this training program two months after a stroke and six months after a stroke.
They compared these two groups with a home exercise program managed by a physical therapist that focused on flexibility, range of motion, strength and balance.
After a year, 52 percent of all the study participants had made significant improvements in their ability to walk. It made no difference whether a patient started physical therapy two or six months after their stroke.
And patients who did therapy at home fared just as well as those who took part in the locomotor training and walking practice at a rehab facility.
Dr. Bruce Dobkin of the University of California at Los Angeles, who helped design the study, said in a statement he had expected the locomotor program to be superior.
“However, we found that all groups did equally well, achieving similar gains in walking speed, motor recovery, balance, social participation and quality of life,” he said.
Home exercise programs require less expensive equipment, less training for the therapists and fewer clinical staff members, and the team suggests this approach may be the best way to get stroke survivors back on their feet.
Editing by Eric Walsh