Study author Pamela Woods Duncan, a professor of community and family medicine at Duke University School of Medicine, said she and her team were surprised to find that patients in the home exercise group did as well as those in locomotor training, which they thought would produce superior results.
Indeed, at the end of one year, more than half (52 percent) of all study participants had improved their walking ability, with similar gains among all three groups. No differences were found among those who had started treadmill training two months or six months after their stroke.
"I think it's an extremely important study," Duncan said. "Those at home had equal outcomes . . . and fewer minor adverse events," such as dizziness and falls.
She and the other researchers also noted that the progressive home exercise program involved less expensive equipment, less training for physical therapists, fewer clinical staff members and better patient compliance.
"Collectively, our results suggest that home exercise is a more pragmatic form of therapy with fewer risks," they wrote.
Libman called the study, published May 26 in the New England Journal of Medicine, "practically revolutionary" for its potential to change standard stroke rehabilitation care.
"I think it's going to change the management of stroke, and third-party payers are going to be extremely interested in the results of the study," he said. "I think it will save a huge amount of money for the healthcare system and be psychologically and emotionally beneficial for patients."
Participants' improvement measurements were based on how well they could walk independently by the end of the study. Severely impaired patients were considered improved if they were able to walk around the inside of a house, while patients already mobile at home were considered improved if they progressed to walking independently in the community.
All rights reserved