Function improved even after conventional therapy, study found
THURSDAY, Aug. 28 (HealthDay News) -- Working out on a treadmill improves brain function and fitness for people who have survived a stroke and gone through the usual rehabilitation program, a new study found.
"You address two problems these patients have," said study researcher Dr. Andreas Luft, a professor of clinical neurology and neurorehabilitation at the University of Zurich in Switzerland. "One is that they don't know how to walk. Not walking, they become deconditioned and lose cardiovascular fitness. With the treadmill type of training, you improve walking and also increase fitness."
Luft worked with physicians at Johns Hopkins University, the University of Maryland and the Baltimore Veterans Affairs Medical Center on the study. It compared the brain and physical function of 37 people who had had strokes and worked on a treadmill three times a week, with 34 people who were given traditional stretching exercises.
After six months, peak walking velocity increased by 51 percent in the treadmill group and just 11 percent in the stretching group. Cardiovascular fitness increased by 18 percent with the treadmill routine, but decreased by 3 percent in the group limited to stretching.
And magnetic resonance imaging showed an increase of blood flow carrying more oxygen to the brainstem and cerebellum for those who worked on the treadmill.
"The most important clinical aspect of the study is that it is saying recovery can occur long after a stroke and can occur even after all the routine therapies have been tried," said Dr. Daniel Hanley, professor of neurology at Johns Hopkins. "Scientifically, the most important point appears to be that rewiring of the brain may be involved in this process, not just body conditioning."
The average age of study participants was 63, and the average time they began the treadmill program was 50 months after the stroke, Hanley noted.
"The average stroke patient now has about eight physical therapy sessions over six to 12 weeks," Hanley said.
The study, published in the Aug. 29 issue of the journal Stroke, shows that treadmill work "should be part of standard treatment for every stroke survivor who has a walking habit," Luft said.
That may not be an easily achievable goal, Luft acknowledged. "Most physical therapy departments have treadmills, but they don't use them to the extent that we used them in the study," he said.
And stroke survivors can't just climb on a treadmill and start walking, Luft said. "Because this is exhausting, it should always be done under supervision," he said. "There is always the risk of running into heart problems and falling. We used special treadmills with handrails and also monitored the heart rate to achieve the level of exertion we needed."
Nevertheless, Hanley said, "the study defies current practice."
Learn more about stroke rehabilitation from the National Institute of Neurological Disorders and Stroke.
SOURCES: Andreas Luft, M.D., professor of clinical neurology and neurorehabilitation, University of Zurich, Switzerland; Daniel Hanley, M.D., professor of neurology, Johns Hopkins University, Baltimore; Aug. 29, 2008, Stroke
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