Evidence for the effectiveness of walking training on walking and self-care after stroke: A systematic review and meta-analysis of randomized controlled trials

Objective: To examine the effect of randomized controlled trials of walking training on walking and self-care in patients with stroke. Data sources: MEDLINE, CINAHL, Embase, PEDro, OTSeeker, Central, and manual search to the end of August 2012. Study selection: English, Finnish, Swedish, or German language walking training randomized controlled trials for patients over 18 years of age with stroke. Data synthesis: The meta-analyses included 38 randomized controlled trials from 44 reports. There was high evidence that in the subacute stage of stroke, specific walking training resulted in improved walking speed and distance compared with traditional walking training of the same intensity. In the chronic stage, walking training resulted in increased walking speed and walking distance compared with no/placebo treatment, and increased walking speed compared with overall physiotherapy. On average, 24 training sessions for 7 weeks were needed. Conclusion: Walking training improves walking capacity and, to some extent, self-care in different stages of stroke, but the training frequency should be fairly high.