Deans' stroke musings: Optimal training strategy for body weight support treadmill training to enhance lower limb motor function and activity of daily living in persons with stroke: a systematic review and meta-analysis of randomized controlled trials

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, September 8, 2025

Optimal training strategy for body weight support treadmill training to enhance lower limb motor function and activity of daily living in persons with stroke: a systematic review and meta-analysis of randomized controlled trials

For me body weight supported treadmill training was worthless. I needed the weight of my body to counteract the spasticity of my legs. And since spasticity never goes away, even now as I'm chronic this would do no good. Overground training is much better in my opinion since it normally gives you perturbations you need to deal with, giving you better balance and preventing falls.

And of course my doctor and therapists DID NOTHING to cure my leg spasticity.

Optimal training strategy for body weight support treadmill training to enhance lower limb motor function and activity of daily living in persons with stroke: a systematic review and meta-analysis of randomized controlled trials

Yan Shi

Junying Liu

Xinxin Zhang^*

Department of Exercise Science, School of Physical Education, Shaanxi Normal University, Xi’an, China

Objective: This meta-analysis aimed to investigate the effect of body weight support treadmill training (BWSTT) on lower limb motor function and daily living activities in a person with a stroke while also exploring the optimal training strategy.

Methods: Six databases (PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang, and SinoMed) were searched up to August 2025. Randomized controlled trials involving persons with stroke, BWSTT, and outcomes measured by the Fugl-Meyer assessment of lower extremity and Barthel Index scores were included. The risk of bias was assessed using the RoB-2 tool of the Cochrane Collaboration, and the certainty of evidence was assessed using the GRADE tool.

Results: 25 studies with 1,749 people with stroke were incorporated into the meta-analysis. The meta-analysis demonstrated that BWSTT significantly outperformed the control group in improving both the Fugl-Meyer lower extremity score (MD = 4.80, 95% CI: 2.90–6.71, p < 0.001) and Barthel Index score (MD = 10.53, 95% CI: 7.61–13.46, p < 0.001). The certainty of evidence was rated as “very low.” The most effective interventions were observed in persons with a disease duration of 3–6 months (Fugl-Meyer: MD = 4.72, 95% CI: 1.54–7.89, p = 0.004; Barthel: MD = 17.58, 95% CI: 11.75–23.40, p < 0.001), intervention time of 4–8 weeks (Fugl-Meyer: MD = 5.78, 95% CI: 3.80–7.76, p < 0.001; Barthel: MD = 12.85, 95% CI: 3.84–21.87, p = 0.005), body weight support over 30% (Fugl-Meyer: MD = 4.51, 95% CI: 1.75–7.28, p = 0.001; Barthel: MD = 10.79, 95% CI: 6.91–14.67, p < 0.001), and gait speeds of 0.2 m/s or higher (Fugl-Meyer: MD = 4.01, 95% CI: 1.62–6.40, p = 0.001; Barthel: MD = 10.61, 95% CI: 1.13–20.10, p = 0.03).

Conclusion: BWSTT improved the lower limb function and daily activities of persons with stroke, with optimal outcomes at disease duration of 3–6 months or undergoing interventions for 4–8 weeks, and more than 30% of the maximum body weight support level or using a gait speed exceeding 0.2 m/s. It is unclear whether persons with disease durations of 3–6 months could achieve the same outcomes as those undergoing 4–8 weeks of intervention. The very low quality of evidence suggests that the conclusions require further validation through high-quality randomized controlled trials.

Systematic review registration: http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42023486562.