Effectiveness of Treadmill Training Intervention for the Management of Patients With Stroke: A Systematic Review and Meta-Analysis

IF 1.9 4区医学 Q2 NURSING

International Journal of Nursing Practice Pub Date : 2025-05-09 DOI:10.1111/ijn.70020

Chenyi Shi, Yuxi Xiao, Dawei Zang, Hongjun Ren

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引用次数: 0

Abstract

Background

Treadmill training, including body weight–supported treadmill training (BWSTT), is widely used in stroke rehabilitation. However, its efficacy in improving walking outcomes may vary depending on patients' baseline functional status.

Objective

This study aims to systematically evaluate effectiveness of treadmill training on walking speed and endurance in stroke survivors and to assess influence of baseline dependency and use of BWSTT.

Methods

We performed systematic review and meta-analysis as per PRISMA 2020 guidelines. Comprehensive search was conducted using Scopus, MEDLINE, EMBASE, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Cochrane Library, Google Scholar and ScienceDirect for studies published from January 1964 to April 2024. Eligible studies were randomized controlled trials assessing treadmill training in stroke patients with outcomes as walking speed and/or endurance. Data extraction and risk of bias assessment were independently performed by two reviewers using Cochrane Risk of Bias-2 tool. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using random effects model. Subgroup analyses were conducted based on baseline dependency and BWSTT use.

Results

Fifty-nine studies were included. Meta-analysis demonstrated significant improvements in walking speed (SMD = 0.255; 95%CI: 0.141–0.369) and walking endurance (SMD = 0.277; 95%CI: 0.134–0.421) among stroke survivors receiving treadmill training. Subgroup analysis revealed that independent participants experienced greater benefits in walking speed (SMD = 0.345) and endurance (SMD = 0.374) compared to dependent participants. Studies employing BWSTT reported enhanced outcomes relative to those without BWSTT. Moderate to high heterogeneity was observed, and publication bias was detected.

Conclusion

Treadmill training, particularly when combined with BWSTT, effectively enhances walking speed and endurance in stroke survivors.

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跑步机训练干预对脑卒中患者管理的有效性：系统回顾和荟萃分析

跑步机训练，包括体重支撑跑步机训练（BWSTT），广泛应用于脑卒中康复。然而，其改善步行结果的功效可能因患者的基线功能状态而异。目的本研究旨在系统评估跑步机训练对脑卒中幸存者步行速度和耐力的影响，并评估基线依赖性和BWSTT使用的影响。方法按照PRISMA 2020指南进行系统评价和荟萃分析。综合检索了Scopus、MEDLINE、EMBASE、中国生物医学文献数据库、中国国家知识基础设施、Cochrane图书馆、谷歌Scholar和ScienceDirect，检索了1964年1月至2024年4月发表的研究。符合条件的研究是随机对照试验，评估跑步机训练对中风患者步行速度和/或耐力的影响。数据提取和偏倚风险评估由两位审稿人使用Cochrane risk of bias -2工具独立完成。采用随机效应模型计算标准化平均差（SMDs）和95%置信区间（ci）。根据基线依赖性和BWSTT使用情况进行亚组分析。结果共纳入59项研究。meta分析显示步行速度显著改善(SMD = 0.255；95%CI: 0.141 ~ 0.369)和步行耐力(SMD = 0.277；95%CI: 0.134-0.421)。亚组分析显示，与依赖者相比，独立参与者在步行速度（SMD = 0.345）和耐力（SMD = 0.374）方面有更大的好处。采用BWSTT的研究报告了相对于不采用BWSTT的患者的改善结果。观察到中度至高度异质性，并发现发表偏倚。结论跑步机训练，特别是与BWSTT联合训练，可有效提高脑卒中幸存者的步行速度和耐力。

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来源期刊

International Journal of Nursing Practice NURSING-

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

3 months

期刊介绍： International Journal of Nursing Practice is a fully refereed journal that publishes original scholarly work that advances the international understanding and development of nursing, both as a profession and as an academic discipline. The Journal focuses on research papers and professional discussion papers that have a sound scientific, theoretical or philosophical base. Preference is given to high-quality papers written in a way that renders them accessible to a wide audience without compromising quality. The primary criteria for acceptance are excellence, relevance and clarity. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.