Effectiveness of community-based ambulation training for walking function of post-stroke hemiparesis: a randomized controlled pilot trial

Objective: To investigate the effect of community-based ambulation training on walking function of patients with post-stroke hemiparesis. Design: Randomized, single-blind, controlled pilot study. Setting: Inpatient rehabilitation hospital. Subjects: Twenty-five subjects were randomly assigned to either the experimental group or the control group, with 13 and 12 subjects, respectively. Interventions: All subjects received a routine physical therapy. The subjects in the experimental group also received community-based ambulation training, which was performed for an hour, once a day, three times a week for a four-week period. Main measures: Ten-metre walk test, 6-minute walk test, community walk test, walking ability questionnaire and activities-specific balance confidence scale before and after the intervention. Results: The change values of the 10-m walk test (0.21 +/- 0.12 m/s versus 0.07 +/- 0.10 m/s), community walk test (-13.61 +/- 10.31 minutes versus -3.27 +/- 11.99 minutes), walking ability questionnaire (6.15 +/- 3.60 score versus 2.75 +/- 2.38 score) and activities-specific balance confidence scale (17.45 +/- 11.55 score versus 2.55 +/- 10.14 score) were significantly higher in the experimental group than in the control group (P < 0.05). At post-test, the 10-m walk test was significantly higher in the experimental group than in the control group (0.72 +/- 0.24 m/s versus 0.50 +/- 0.23 m/s) (P < 0.05). In the experimental group, there were significant differences for all variables between pre-test and post-test (P < 0.01), whereas the subjects of the control group showed a significant difference in only the walking ability questionnaire (P < 0.01). Conclusions: The findings demonstrate that community-based ambulation training can be helpful in improving walking ability of patients with post-stroke hemiparesis and may be used as a practical adjunct to routine rehabilitation therapy.