An electromechanical gait trainer for ambulation training after stroke

INTERVENTION: The electromechanical gait trainer (GT) is a gait training machine which uses 2 driven footplates to simulate the phases of gait. Participants would be put into this GT by two therapy assistants. The GT group received 45 minutes of physiotherapy 6 times per week for 8 weeks, comprising 20 minutes of GT training, 5 minutes of stance/gait training, 10 minutes of standing and 10 minutes of cycling. 10 minutes of standing and 10 minutes of cycling were assisted by two TAs with the help of an alarm clock. Each stance and gait training session was structured to be 5 minutes. It was delivered face‐to‐face individually by an experienced physiotherapist with at least 5 years of working experience in the neurological field. A progression of task difficulty in terms walking and dynamic standing balance was tailored to suit participants' capability. There were no intervention adherence assessments by external parties. CONDITION: Ambulation Stroke PRIMARY OUTCOME: Cost effectiveness ; Relative cost effectiveness of one treatment over the other was assessed as the difference in costs between treatments divided by the difference in health status outcomes between treatments. ; Given the equivalence of clinical effectiveness, a cost‐minimisation analysis was conducted to determine the most cost‐effective option. ; The cost of each treatment was calculated by identifying and estimating the staff and equipment costs required to undertake each procedure. ; ; SECONDARY OUTCOME: Functional ambulatory Categories. ; This is a measure of gait ability. It is graded from 0 (non‐ambulant) to 5 (independent ambulation). The participants walked a 15‐m distance. If appropriate they will negotiate a short staircase with a rail. Gait endurance‐ 6 minute walk test Gait speed ; The time taken to cover 10 meter on a level surface. Health status was also measured with the Stroke Impact Scale (SIS) memory & thinking, mood and emotion, communication, participation & recovery. Health status was measured with the Stroke Impact Scale (SIS) physical component. Modified Barthel Index ; This measures general independence in activity of daily function consisting of 10 items such as transfers, ambulation and stair climbing. It has a minimum score of 0 (completely dependent) to 100 (completely independent) INCLUSION CRITERIA: Inclusion criteria were: 1) unilateral hemorrhagic/ischemic stroke 2) age 18‐80 years 3) independent ambulation pre‐stroke