Rehabilitation including treadmill therapy for patients with incomplete locked-in syndrome after stroke; a case series study of motor recovery

Primary objective: The aim of this study was to explore changes in motor function in patients with incomplete LIS referred to rehabilitation. Research design: A prospective, explorative, multiple case study design was applied. Methods and procedures: A multidisciplinary intervention programme was conducted including treadmill therapy (TT) with body weight support. Patients being able to stand upright supported by a standing frame were consecutively recruited to TT from 2001-2005. Physical performance was recorded on video and treadmill data were registered. Performances of transfer and walking were selected as the focus of observation. Two external observers described the performances independently, using an observational form and validated the joint and condensed descriptions. Outcomes and results: A total of nine patients fulfilled the intervention programme and no adverse events were noted. Personal assistance and body weight support were reduced during the TT period and all patients demonstrated improved physical performance. While five patients were able to practice some kind of walking activity at the end of rehabilitation, four patients demonstrated improvement in body functions, showing better postural control. Conclusion: This study indicates that TT can be a safe and useful method to intensify the rehabilitation programme for patients with incomplete LIS.