Treadmill-training researchTreadmill-Training Benefits Stroke PatientsTreadmill-training has been making headlines recently in stroke therapy treatment (www.know-stroke.org) and other rehabilitation treatment protocols. From the fitness point of view, we have known for some time that studies have shown that people get more out of a treadmill than other fitness equipment because it is natural to walk or run, and users are more apt to stick with it for longer each session. This article will review a recent study using treadmills in stroke rehabilitation, as well as at some of the latest treadmill products on the market today.
The Research According to recent research at Johns Hopkins University School of Medicine, Baltimore, people who use treadmill-training can significantly improve their health and mobility. The results of this study, validated through brain imaging, that brain changes reflected actual neural "rewiring" -even years after having a stroke. The study's results, published in Stroke, the journal of the American Heart Association, suggest that patients' brains may retain the capacity to rewire through a treadmill exercise program months or years after conventional physical therapy has ended.1 For this study, investigators combined efforts to recruit 71 patients who had a stroke at least 6 months earlier, with an average time lapse of nearly 4 years. At the study's onset, half of the subjects could walk without assistance, while the rest used a cane, a walker, or a wheelchair. All of the subjects, separated into two random groups regardless of disability, were tested for mobility and aerobic capacity (also known as VO2 peak), a measure of cardiac fitness. Thirty-two patients drawn equally from both groups underwent functional magnetic resonance imaging (fMRI) to assess brain activity linked to moving their legs in a walking motion. One group then participated in an exercise program that principally involved walking on a treadmill three times per week for up to 40 minutes, assisted by a supporting sling and tether if needed. PTs assigned to each subject increased the intensity of the workouts over time by increasing the treadmills' speed and incline, though the workouts never taxed the patients beyond a moderate level of 60% VO2 peak. With the second group of patients, therapists assisted the patients in performing stretching exercises for the same period of time. After 6 months, patients were again tested for walking speed and VO2 peak, and the same group who had undergone fMRI was rescanned. Walking speed for the treadmill group increased 51%, compared to about 11% faster for those in the stretching group. Ground walking speed among the treadmill exercisers increased 19%, compared to about 8% for the stretchers. The treadmill exercisers also were significantly more fit at study completion, with VO2 peak increasing by about 18%. VO2 peak decreased slightly in the stretching group. Hoping to find evidence that improved brain activity was responsible for the results, the investigators analyzed the brain scans and found markedly increased metabolic activity in brain stem areas associated with walking among all the treadmill exercisers. Brain scans of patients in the stretching group showed no such changes. Those patients with the most improvement in walking showed the strongest change in brain activity, though the researchers don't yet know whether these brain changes were caused by more walking or whether participants walked better because brain activity in these key areas increased. This question will be the focus of a future study.
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How a PFO caused my stroke
by David Dansereau,MS,PTWhile I have remained mostly silent about this issue over this past year, I now know I must let everyone hear my message so that I can help do something to educate others about patent-foramen-ovale and stroke risk. Several months ago I had a stroke. It was revealed after months of testing (and still some uncertainty) that it was caused by a defect in my heart from birth called a patent-foramen-ovale or PFO . The few people I had spoke to about this to this point were on a need to know basis and even then, I summed it up to them as “remember what happened to Tedy Bruschi of the New England Patriots at the end of the 2005 football season?”. If you don’t know about his story, he also had a stroke from a PFO. I’d like to take the time to tell you now about my experience. Click this link if you'd like to learn more...
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