Background

Individuals poststroke experience gait asymmetries that result in decreased community ambulation and a lower quality of life. A variety of studies have utilized split-belt treadmill training to investigate its effect on gait asymmetry, but many employ various methodologies that report differing results.

Objective

The purpose of this meta-analysis was to determine the effects of split-belt treadmill walking on step length symmetry in individuals poststroke both during and following training.

Methods

A comprehensive search of PubMed/MEDLINE, CINAHL, Web of Science, and Scopus was conducted to find peer-reviewed journal articles that included individuals poststroke that participated in a split-belt treadmill walking intervention. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to assess risk of bias. Pooled Hedge’s g with random effects models were used to estimate the effect of split-belt training on step length symmetry.

Results

Twenty-one studies were assessed and included in the systematic review with 11 of them included in the meta-analysis. Included studies had an average STROBE score of 16.2 ± 2.5. The pooled effects for step length asymmetry from baseline to late adaptation were not significant (g = 0.060, P = .701). Large, significant effects were found at posttraining after a single session (g = 1.04, P < .01), posttraining after multiple sessions (g = −0.70, P = .01), and follow-up (g = −0.718, P = .023).

Conclusion

Results indicate split-belt treadmill training with the shorter step length on the fast belt has the potential to improve step length symmetry in individuals poststroke when long-term training is implemented, but randomized controlled trials are needed to confirm the efficacy of split-belt treadmill training.

中文翻译：

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分离式跑步机干预对卒中后个体步长不对称的影响：荟萃分析的系统评价

背景

中风后个体的步态不对称会导致社区活动减少和生活质量下降。各种研究利用分带式跑步机训练来研究其对步态不对称的影响，但许多研究采用了不同的方法，报告了不同的结果。

客观的

这项荟萃分析的目的是确定分带式跑步机行走对训练期间和训练后个人中风后步长对称性的影响。

方法

对 PubMed/MEDLINE、CINAHL、Web of Science 和 Scopus 进行了全面搜索，以找到经过同行评审的期刊文章，其中包括参与分带式跑步机步行干预的中风后患者。加强流行病学观察性研究报告（STROBE）用于评估偏倚风险。Pooled Hedge's g与随机效应模型用于估计分带训练对步长对称性的影响。

结果

对 21 项研究进行了评估并纳入系统评价，其中 11 项纳入荟萃分析。纳入研究的平均 STROBE 得分为 16.2 ± 2.5。从基线到后期适应的步长不对称的汇总效应不显着（g = 0.060，P = .701）。在单次训练后的训练后 ( g = 1.04, P < .01)、多次训练后的训练后 ( g = -0.70, P = .01) 和后续训练 ( g = -0.718, P = .023)。

结论

结果表明，在进行长期训练时，在快带上使用较短步长的分带式跑步机训练有可能改善个体中风后步长的对称性，但需要随机对照试验来确认分带式跑步机的功效训练。