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Cited by 190Stroke Rehabilitation and RecoverySpinal Cord Injury ResearchAcute Ischemic Stroke Management

Aerobic treadmill plus Bobath walking training improves walking in subacute stroke: a randomized controlled trial

Eich, H-J, Mach, H, Werner, C, Hesse, S·2004·Clinical Rehabilitation
DOI 10.1191/0269215504cr779oa
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Abstract

Objective: To evaluate the immediate and long-term effects of aerobic treadmill plus Bobath walking training in subacute stroke survivors compared with Bobath walking training alone. Design: Randomized controlled trial. Setting: Rehabilitation unit. Subjects: Fifty patients, first-time supratentorial stroke, stroke interval less than six weeks, Barthel Index (0 / 100) from 50 to 80, able to walk a minimum distance of 12 m with either intermittent help or stand-by while walking, cardiovascular stable, minimum 50 W in the bicycle ergometry, randomly allocated to two groups, A and B. Interventions: Group A 30 min of treadmill training, harness secured and minimally supported according to patients' needs, and 30 min of physiotherapy, every workday for six weeks, speed and inclination of the treadmill were adjusted to achieve a heart rate of HR: (Hrmax / HRrest)*0.6 / HRrest; in group B 60 min of daily physiotherapy for six weeks. Main outcome measures: Primary outcome variables were the absolute improvement of walking velocity (m/s) and capacity (m), secondary were gross motor function including walking ability (score out of 13) and walking quality (score out of 41), blindly assessed before and after the intervention, and at follow-up three months later. Results: Patients tolerated the aerobic training well with no side-effects, significantly greater improvement of walking velocity and capacity both at study end (p / 0.001 versus p / 0.002) and at follow-up (p < 0.001 versus p<0.001) in the experimental group. Between weeks 0 and 6, the experimental group improved walking speed and capacity by a mean of.31 m/s and 91 m, the control group by a mean of 0.16 m/s and 56 m. Between weeks 0 and 18, the experimental group improved walking speed and capacity by a mean of 0.36 m/s and 111 m, the control group by a mean of 0.15 m/s and 57 m. Gross motor function and walking quality did not differ at any time. Conclusions: Aerobic treadmill plus Bobath walking training in moderately affected stroke patients was better than Bobath walking training alone with respect to the improvement of walking velocity and capacity. The treatment approach is recommended in patients meeting the inclusion criteria. A multicentre trial should follow to strengthen the evidence.

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  • Not all studies in the review are true comparative studies between approaches; 4 studies reported comparison of alternative approaches as an adjunct to Bobath therapy.

    “A further consideration is the fact that not all studies are true comparative studies between approaches; 4 studies in this review reported comparison of alternative approaches as an adjunct to Bobath therapy (treadmill training, 38 Rhythmic Auditory Stimulation, 49,55 and independent standing practice 47 ).”

    From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [38]

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Authors
Eich, H.-J., Mach, H., Werner, C., & Hesse, S.
Affiliations
Freie Universität Berlin (DE)
ORCID
Hesse, S
Venue
Clinical Rehabilitation
Publisher
SAGE Publications
Published
2004-09
Volume
18
Issue
6
Pages
640-651
ISSN
  • 0269-2155 (ISSN-L)
  • 1477-0873
DOI
10.1191/0269215504cr779oa
OpenAlex
W2098485932
Cited by
190
References
21
Citations by year
2026: 3 · 2025: 5 · 2024: 10 · 2023: 3 · 2022: 3 · 2021: 6 · 2020: 3 · 2019: 10 · 2018: 4 · 2017: 5 · 2016: 11 · 2015: 13 · 2014: 17 · 2013: 9 · 2012: 8
FWCI
8.83
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Clinical Rehabilitation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
Keywords
subacute stroke, walking speed, walking capacity, stroke rehabilitation, gait, physiotherapy, gross motor function, walking distance, supratentorial stroke, long-term follow-up
MeSH terms
Stroke Rehabilitation, Aged, Exercise Therapy, Hemiplegia, Humans, Middle Aged, Exercise, Walking, Physical Therapy Modalities

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