Mobility Research : In Step With 2012 Volume 6 Issue 01

2012 will be a busy year for The MR Institute of Continuing Education. MR ICE has a full schedule of online and onsite educational events currently available and adding more each day! We remain committed to meeting the needs of rehab professionals in this continually changing health care environment. In order to provide effective care, clinicians must learn about scientific advances that lead to new evidence based clinical practices.

This quarterly newsletter is our virtual meeting place to bring you new and clinically relevant information. Designed with the busy therapist in mind – we provide quick access to the featured research article, new courses and seminars, great customer stories and information about product updates and upgrades.

Journal Club, Presenter Series clinical webinars, CEU onsite seminars, clinical training presentations- these are just a few ways we deliver on our mission to provide quality educational experiences. This month we have a Journal Club SPECIAL presentation on January 12th with first author Therese Johnston, PT, PhD, MBA to further discuss the SSTEPS trial methodology, findings and implications. Then be sure to join us for the regular Journal Club program discussing the featured article below.

Featured Research Article

J Physiotherapy 56:97-103.
Dean, CM, Ada, L, Bampton, J, Morris, ME, Katrak, PH, Potts, S (2010).

Introduction by Nechama Karman, PT
This paper reviews the secondary outcomes of the MOBILISE trial, a large, prospective, multi-site randomized trial comparing body weight supported treadmill training to assisted over-ground gait training in non-ambulatory stroke survivors during their inpatient rehabilitation stay. Ada, et al (2010), in presenting primary data from the same trial, demonstrated that non-ambulatory stroke survivors receiving body weight supported treadmill training (BWSTT) practiced walking more than those training over-ground despite spending the same amount of in physical therapy (30 minutes).

Click to read more.

The Bottom Line

What We Know

BWSTT provides more practice – from 2x as much to 5x the amount of walking practice – than over ground gait training, with the same amount of rehab resources (time, personnel). Treadmill walking differs biomechanically from over ground walking.

New Information

Recipients of BWSTT post-stroke walked further, faster, and with longer stride at 6 months, than those who trained over-ground.

What This Means to You

The fear that BWSTT would have a deleterious effect on walking quality is unfounded. Clinicians should therefore feel confident about implementing this intervention.

Research Summary

As previously reported, 72% (43/60) of BWSTT subjects achieved independent walking by 6 months, as compared to 60% (36/60) of over-ground subjects in the MOBILISE trial. Rates of achieving (I) ambulation for IP rehab patients post-stroke in Australia are 50%. This paper looked at secondary data from the same study, to determine whether there were qualitative differences between those receiving BWS TT and those receiving over-ground gait training post-stroke. While many outcomes were not statistically significantly different between groups, the BWSTT subjects demonstrated greater walking capacity (6 MWT) than the over-ground subjects, and the differences between groups in walking speed may be clinically important. Most importantly, BWSTT was not found to have a negative impact on walking quality in the study population of non-ambulatory stroke patients

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