Stroke Victims Should Use the Treadmill

After a stroke, most patients with lower limb involvement have an abnormal gait – mobility is limited and, unless corrected, there may be permanent disability. So the results of research conducted by Johns Hopkins, the University of Maryland, and the Veterans Affairs Administration, and posted in the journal Stroke, is most welcome.

Because the movements involved in walking are so complex, the scientists theorized that repetitive treadmill exercise could possibly lead to ‘rewiring’ remaining nervous pathways in the brain, by a process known as neuron plasticity.

Six months’ repetitive treadmill exercise (37 patients) was compared for its effect with that of stretching exercises for the same duration (34 patients). They were supported by a sling or tether, if necessary. Walking speed, aerobic fitness (using VO2max), and, in some patients, brain activation (measured by functional MRI) were assessed.

The treadmill patients improved their speed by 51% and their cardiovascular fitness by 18%, compared with the stretching patients. There was also an improvement in the measured brain activation, during movement of the paralyzed-side limbs but not of the non-paralyzed limbs. In particular, the cerebellum – the part of the brain concerned with integration of sensory perception, coordination and movement control – was activated.

These results are important because they were obtained in people who had had a stroke 6 months to 4 years previously. They show that stroke damage is not irreversible, and that exercise can help the body recover months or years after conventional physical therapy has ended. Stoke is clearly one condition where it’s imperative not to give up.