Effectiveness of gait training using an electromechanical gait trainer, with and without functional electric stimulation, in subacute stroke: A randomized controlled trial

Objective: To compare the therapeutic effects of conventional git training (CGT), gait training using an electromechanical gait trainer (EGT), and gait training using an electromechanical gait trainer with functional electric stimulation (EGT-FES) in people with subacute stroke. Design: Nonblinded randomized controlled trial. Setting: Rehabilitation hospital for adults. Participants: Fifty patients were recruited within 6 weeks after stroke onset; 46 of these completed the 4-week training period. Intervention: Participants were randomly assigned to I of 3 gait intervention groups: CGT, EGT, or EGT-FES. The experimental intervention was a 20-minute session per day, 5 days a week (weekdays) for 4 weeks. In addition, all participants received their 40-minute sessions of regular physical therapy every weekday as part of their treatment by the hospital. Main Outcome Measures: Five-meter walking speed test, Elderly Mobility Scale (EMS), Berg Balance Scale, Functional Ambulatory Category (FAC), Motricity Index leg subscale, FIM instrument score, and Barthel Index. Results: The EGT and EGT-FES groups had statistically significantly more improvement than the CGT group in the 5-m walking speed test (CGT vs EGT, P=.01; CGT vs EGT-FES, P=.001), Motricity Index (CGT vs EGT-FES, P=.01), EMS (CGT vs EGT, P=.006; CGT vs EGT-FES, P=.009), and FAC (CGT vs EGT, P=.005; CGT vs EGT-FES, P=.002) after the 4 weeks of training. No statistically significant differences were found between the EGT and EGT-FES groups in all outcome measures. Conclusions: In this sample with subacute stroke, participants who trained on the electromechanical gait trainer with body-weight support, with or without FES, had a faster gait, better mobility, and improvement in functional ambulation than participants who underwent conventional gait training. Future studies with assessor blinding and larger sample sizes are warranted.