Efficacy of an Electromechanical Gait Trainer Poststroke in Singapore: A Randomized Controlled Trial

Objective To evaluate the longer-term effects of electromechanical gait trainers (GTs) combined with conventional physiotherapy on health status, function, and ambulation in people with subacute stroke in comparison with conventional physiotherapy given alone. Design Randomized controlled trial with intention-to-treat analysis. Setting Community hospital in Singapore. Participants Nonambulant individuals (N=106) recruited approximately 1 month poststroke. Interventions Both groups received 45 minutes of physiotherapy 6 times per week for 8 weeks as follows: the GT group received 20 minutes of GT training and 5 minutes of stance/gait training in contrast with 25 minutes of stance/gait training for the control group. Both groups completed 10 minutes of standing and 10 minutes of cycling. Main Outcome Measures The primary outcome was the Functional Ambulation Category (FAC). Secondary outcomes were the Barthel Index (BI), gait speed and endurance, and Stroke Impact Scale (SIS). Measures were taken at baseline and 4, 8, 12, 24, and 48 weeks. Results Generalized linear model analysis showed significant improvement over time (independent of group) for the FAC, BI, and SIS physical and participation subscales. However, no significant group × time or group differences were observed for any of the outcome variables after generalized linear model analysis. Conclusions The use of GTs combined with conventional physiotherapy can be as effective as conventional physiotherapy applied alone for people with subacute stroke.