RESEARCH REPORT POSTER DISPLAY

EXERCISE TRAINING IMPROVES WALKING FUNCTION IN AN AFRICAN GROUP OF STROKE SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. Olawale O¹, Appiah-Kubi K², Jones-Okai D²; ¹School of Allied Health Sciences, University of Ghana, Accra. ²Korle Bu Teaching Hospital, Accra, Ghana

PURPOSE: The purpose of this study was to evaluate the effects of exercise training on walking function in an African group of adult patients with stroke. RELEVANCE: Walking is possible for the majority of patients following stroke, but it rarely returns to normal. Therapeutic interventions to improve walking after stroke vary considerably. Although there is emerging evidence that rehabilitation can be effective in improving functional mobility status, systematic trials comparing the relative effectiveness of various intervention types have been few in number and suboptimal in design. PARTICIPANTS: Participants were sixty (60) adult patients with stroke. They were recruited from a population of African stroke patients receiving outpatient physiotherapy treatment at the Physiotherapy Department, Korle Bu Teaching Hospital, Accra. METHODS: Sixty-four (64) adult patients with stroke were randomized to three study groups. All patients received individual out-patient conventional physiotherapy rehabilitation for 12 weeks. Patients in Group A, in addition, received ECG-monitored treadmill exercise training for the 12 weeks. Patients in Group B, in addition, received ECG-monitored over-ground walking exercise training for the 12 weeks. Patients in Group C (Control) received conventional physiotherapy rehabilitation only. Each therapy session lasted approximately 1 hour a day and across 3 days a week. The main outcome measures were (i) Ten-metre walk time test and (ii) Six-minute walk distance test. These were evaluated at entry into the study and fortnightly till the end of the study period. Sixty (60) patients (20 in each group) completed the 12 weeks of treatment / training. ANALYSIS: Paired t-tests were used to evaluate the significance of the difference between the pre-training and post-training mean scores on the ten-metre walk time and the six-minute walk distance tests for each of the three groups (p < 0.05). RESULTS: Compared with controls, the exercise groups showed significant gains in waking function demonstrated by improved ambulatory performance on 10-metre walks and 6-minute walks. Statistical analysis showed significant differences between the pre-training and post-training mean scores on the ten-metre walk time and the six-minute walk distance tests for the treadmill and over-ground walking groups but not for the control group (p < 0.05). CONCLUSIONS: A supervised exercise training programme was highly effective in improving walking function in adult patients with stroke; and could be combined with conventional rehabilitation commonly used in most stroke-care units. IMPLICATIONS: Patients with stroke can benefit from structured exercise training that involves basic and natural movement patterns. Therefore, professionals who design and conduct stroke rehabilitation programs should consider allocating more time to exercise training to optimize patient outcomes. KEYWORDS: Stroke, Stroke rehabilitation, Exercise training, Walking. FUNDING ACKNOWLEDGEMENTS: Nil. CONTACT: jideolawale@yahoo.com

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