Home Care stroke patients achieve similar outcome walking results to in clinic patients

National Institutes of Health steering committee shows that stroke patients who had a home physical therapy exercise program improved just as well as those who did the locomotor training.
Results from the LEAPS Locomotor Experience Applied Post Stroke Trial presented were presented by Dr. Bruce Dobkin at the American Stroke Association's International Stroke Conference 2011 in Los Angeles. The study funded primarily by the NIH's National Institute of Neurological Disorders and Stroke, with additional support from the National Center for Medical Rehabilitation showed that at an home walking exercise program achieved similar gains to a body-weight supported treadmill program.
The body-weight supported treadmill training and home based walking practice was started at two different stages, either two months after stroke or six months after stroke with the early intervention group achieving better functional gains. Outcome measures used included speed and distance of the patients walking, their physical mobility, motor recovery and social participation and improvement in quality of life. It was further concluded that the at home exercise program supported by a physical therapist required less expensive equipment, less training for the therapists and fewer clinical staff members.
"We were pleased to see that stroke patients who had a home physical therapy exercise program improved just as well as those who did the locomotor training,'' said LEAPS principal investigator Pamela W. Duncan, a professor at Duke University School of Medicine and a former student of Dobkin's. "The home physical therapy program is more convenient and pragmatic. Usual care should incorporate more intensive exercise programs that are easily accessible to patients to improve walking, function and quality of life."
The LegTutor and 3DTutor systems incorporate the concept of virtual functional tasks which are used to motivate the patient to do intensive active exercise practice. The LegTutor can be used by patients who can not support their body weight as well as by patients doing closed chain standing exercises. The LegTutor and 3DTutor provide both feedback on the patient’s movement ability and instructions on how to move the joint in association with another joint thus allowing for exercise training without the patient adopting compensatory movement patterns. This allows the patient to practice isolated and combined movements of the hip and knee and ankle when they exercise with the LegTutor and 3DTTutor. The system can be used by the patient in clinic and at home with home care patients being supported by tele-rehabilitation.