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Stroke patients live with balance and walking dysfunction. Walking is the most important factor for independent community activities. The purpose of this study was to investigate the effect of a community walking training program (CWTP) within the real environment on walking function and social participation in chronic stroke patients. Twenty-two stroke patients (13 male, 50.45 years old, post stroke duration 231.64 days) were randomly assigned to either the CWTP group or the control group. All subjects participated in the same standard rehabilitation program consisting of physical and occupational therapy for 60 min per day, five times a week, for four weeks. In addition, the CWTP group participated in CWTP for 30 min per day, five times a week, for four weeks. Walking function was assessed using the 10-m walk test (measurement for 10-meter walking speed), 6-min walk assessment (measurement of gait length for 6-minutes), and community gait assessment. Social participation was assessed using a social participation domain of stroke impact scale. In walking function, greater improvement was observed in the CWTP group compared with the control group (P < 0.05). In addition, social participation improved more in the CWTP group compared with the control group (P < 0.05). These findings demonstrate the efficacy of CWTP on walking function and social participation in chronic stroke patients. Therefore, we suggest that CWTP within the real environment may be an effective method for improving walking function and social participation of chronic stroke patients when added to standard rehabilitation.
Kim et al. (2014) studied this question.