Is the Intensity or Duration of Treadmill Training Important for Stroke Patients? A Meta-Analysis.

BACKGROUND: Stroke, the third highest cause of death after cancer and cardiac diseases, is a strong cause of adult disability in most countries. Therefore, the aim of the current meta-analysis was to examine the most effective intensity and duration of treadmill training on motor performance in stroke subjects.

METHODS: Suitable studies were recognized from January 1980 to July 2015 using PubMed as the main search engine. There were noticeable biases such as training intensity, training duration (≥2 weeks), relative training intensity, and Vo2max, which were controlled. Subgroup classifications for human studies were prepared based on previous studies and were determined as follows: low intensity (≤.6 m/s)-low volume/duration (≤500 minutes), low intensity (≤.6 m/s)-high volume/duration (>500 minutes), high intensity (>.6 m/s)-low volume/duration (≤500 minutes), and high intensity (>.6 m/s)-high volume/duration (>500 minutes).

RESULTS: Forty-nine articles were identified for human studies. This meta-analysis exhibited treadmill training regardless if intensity and volume/duration had a significantly greater recovery of motor function than did no training (standard mean difference [SMD] = .601; 95% confidence interval [CI] = .546-.657; P = .0001). Also, for the low-intensity, low-volume/-duration strategy, training on a treadmill displayed a significantly greater motor function rehabilitation than did no training (SMD = .75; 95% CI = .64-.85; P = .0001).

CONCLUSIONS: The current meta-analysis showed that low-intensity (≤.6 m/s)-high-duration/-volume (>500 minutes) treadmill training as a rehabilitation strategy had the highest SMD to ameliorate stroke-induced dysfunctions compared with the other strategies.