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Comparison 1 Treadmill and body weight support versus other interventions, Outcome 1 dependence on personal assistance to walk at end of treatment phase.
Figures and Tables -
Analysis 1.1

Comparison 1 Treadmill and body weight support versus other interventions, Outcome 1 dependence on personal assistance to walk at end of treatment phase.

Comparison 1 Treadmill and body weight support versus other interventions, Outcome 2 walking speed (m/sec) at end of treatment phase.
Figures and Tables -
Analysis 1.2

Comparison 1 Treadmill and body weight support versus other interventions, Outcome 2 walking speed (m/sec) at end of treatment phase.

Comparison 1 Treadmill and body weight support versus other interventions, Outcome 3 walking endurance (m) at end of treatment phase.
Figures and Tables -
Analysis 1.3

Comparison 1 Treadmill and body weight support versus other interventions, Outcome 3 walking endurance (m) at end of treatment phase.

Comparison 1 Treadmill and body weight support versus other interventions, Outcome 4 dependence on personal assistance to walk at end of scheduled follow up.
Figures and Tables -
Analysis 1.4

Comparison 1 Treadmill and body weight support versus other interventions, Outcome 4 dependence on personal assistance to walk at end of scheduled follow up.

Comparison 1 Treadmill and body weight support versus other interventions, Outcome 5 walking speed (m/sec) at end of scheduled follow up.
Figures and Tables -
Analysis 1.5

Comparison 1 Treadmill and body weight support versus other interventions, Outcome 5 walking speed (m/sec) at end of scheduled follow up.

Comparison 1 Treadmill and body weight support versus other interventions, Outcome 6 walking endurance (m) at end of scheduled follow up.
Figures and Tables -
Analysis 1.6

Comparison 1 Treadmill and body weight support versus other interventions, Outcome 6 walking endurance (m) at end of scheduled follow up.

Comparison 2 Treadmill only versus other interventions, Outcome 1 walking speed (m/sec) at end of treatment phase.
Figures and Tables -
Analysis 2.1

Comparison 2 Treadmill only versus other interventions, Outcome 1 walking speed (m/sec) at end of treatment phase.

Comparison 2 Treadmill only versus other interventions, Outcome 2 walking endurance (m) at end of treatment phase.
Figures and Tables -
Analysis 2.2

Comparison 2 Treadmill only versus other interventions, Outcome 2 walking endurance (m) at end of treatment phase.

Comparison 3 Treadmill and body weight support versus treadmill only, Outcome 1 dependence on personal assistance to walk at end of treatment phase.
Figures and Tables -
Analysis 3.1

Comparison 3 Treadmill and body weight support versus treadmill only, Outcome 1 dependence on personal assistance to walk at end of treatment phase.

Comparison 3 Treadmill and body weight support versus treadmill only, Outcome 2 walking speed (m/sec) at end of treatment phase.
Figures and Tables -
Analysis 3.2

Comparison 3 Treadmill and body weight support versus treadmill only, Outcome 2 walking speed (m/sec) at end of treatment phase.

Comparison 3 Treadmill and body weight support versus treadmill only, Outcome 3 walking endurance (m) at end of treatment phase.
Figures and Tables -
Analysis 3.3

Comparison 3 Treadmill and body weight support versus treadmill only, Outcome 3 walking endurance (m) at end of treatment phase.

Comparison 3 Treadmill and body weight support versus treadmill only, Outcome 4 dependence on personal assistance to walk at end of scheduled follow up.
Figures and Tables -
Analysis 3.4

Comparison 3 Treadmill and body weight support versus treadmill only, Outcome 4 dependence on personal assistance to walk at end of scheduled follow up.

Comparison 3 Treadmill and body weight support versus treadmill only, Outcome 5 walking speed (m/sec) at end of scheduled follow up.
Figures and Tables -
Analysis 3.5

Comparison 3 Treadmill and body weight support versus treadmill only, Outcome 5 walking speed (m/sec) at end of scheduled follow up.

Comparison 3 Treadmill and body weight support versus treadmill only, Outcome 6 walking endurance (m) at end of scheduled follow up.
Figures and Tables -
Analysis 3.6

Comparison 3 Treadmill and body weight support versus treadmill only, Outcome 6 walking endurance (m) at end of scheduled follow up.

Comparison 4 Treadmill and other task‐oriented exercise versus other interventions, Outcome 1 dependence on personal assistance to walk at end of treatment phase.
Figures and Tables -
Analysis 4.1

Comparison 4 Treadmill and other task‐oriented exercise versus other interventions, Outcome 1 dependence on personal assistance to walk at end of treatment phase.

Comparison 4 Treadmill and other task‐oriented exercise versus other interventions, Outcome 2 walking speed (m/sec) at end of treatment phase.
Figures and Tables -
Analysis 4.2

Comparison 4 Treadmill and other task‐oriented exercise versus other interventions, Outcome 2 walking speed (m/sec) at end of treatment phase.

Comparison 4 Treadmill and other task‐oriented exercise versus other interventions, Outcome 3 walking endurance (m) at end of treatment phase.
Figures and Tables -
Analysis 4.3

Comparison 4 Treadmill and other task‐oriented exercise versus other interventions, Outcome 3 walking endurance (m) at end of treatment phase.

Comparison 4 Treadmill and other task‐oriented exercise versus other interventions, Outcome 4 dependence on personal assistance to walk at end of scheduled follow up.
Figures and Tables -
Analysis 4.4

Comparison 4 Treadmill and other task‐oriented exercise versus other interventions, Outcome 4 dependence on personal assistance to walk at end of scheduled follow up.

Comparison 4 Treadmill and other task‐oriented exercise versus other interventions, Outcome 5 walking speed (m/sec) at end of scheduled follow up.
Figures and Tables -
Analysis 4.5

Comparison 4 Treadmill and other task‐oriented exercise versus other interventions, Outcome 5 walking speed (m/sec) at end of scheduled follow up.

Comparison 4 Treadmill and other task‐oriented exercise versus other interventions, Outcome 6 walking endurance (m) at end of scheduled follow up.
Figures and Tables -
Analysis 4.6

Comparison 4 Treadmill and other task‐oriented exercise versus other interventions, Outcome 6 walking endurance (m) at end of scheduled follow up.

Comparison 5 Adverse events for all included trials, Outcome 1 Adverse events during the treatment phase.
Figures and Tables -
Analysis 5.1

Comparison 5 Adverse events for all included trials, Outcome 1 Adverse events during the treatment phase.

Comparison 6 Dropouts for all included trials, Outcome 1 Dropouts.
Figures and Tables -
Analysis 6.1

Comparison 6 Dropouts for all included trials, Outcome 1 Dropouts.

Comparison 7 First post‐hoc sensitivity analysis: all trials involving treadmill training, Outcome 1 Walking speed (m/sec) at end of treatment phase.
Figures and Tables -
Analysis 7.1

Comparison 7 First post‐hoc sensitivity analysis: all trials involving treadmill training, Outcome 1 Walking speed (m/sec) at end of treatment phase.

Comparison 8 Second post‐hoc sensitivity analysis: all trials involving body weight support, Outcome 1 walking speed (m/sec) at end of treatment phase.
Figures and Tables -
Analysis 8.1

Comparison 8 Second post‐hoc sensitivity analysis: all trials involving body weight support, Outcome 1 walking speed (m/sec) at end of treatment phase.

Comparison 9 Third post‐hoc sensitivity analysis: data reported by trialists, Outcome 1 walking speed (m/sec) at end of treatment phase.
Figures and Tables -
Analysis 9.1

Comparison 9 Third post‐hoc sensitivity analysis: data reported by trialists, Outcome 1 walking speed (m/sec) at end of treatment phase.

Table 1. Participant characteristics

STUDY ID

EXP age

CTL age

EXP gender

CTL gender

EXP time post stroke

CTL time post stroke

EXP paresis side

CTL paresis side

Ada 2003

Mean 66 (SD 11) years (excluding 1 dropout)

Mean 66 (SD 11) years (excluding 1 dropout)

Male/female 9/4

Male/female 10/4

Mean 28 (SD 17) months

Mean 26 (SD 20) months

Left/right 5/8

Left/right 8/6

da Cunha Filho 2002

Mean 57.8 (SD 5.5) years (excluding dropouts)

Mean 58.9 (SD 12.9) years (excluding dropouts)

Male/female 6/0

Male/female 7/0

Mean 15.7 (SD 7.7) days

Mean 19.0 (SD 12.7) days

Left/right/bilateral 1/4/1

Left/right 4/3

Dean 2000

Mean 66.2 (SD 7.7) years (all participants)

Mean 62.3 (SD 6.6) years

Male/female 3/3

Male/female 4/2

Mean 2.3 (SD 0.7) years

Mean 1.3 (SD 0.9) years

Left/right 3/3

Left/right 2/4

Eich 2004

Mean 62.4 (SD 4.8) years (all participants)

Mean 64.0 (SD 6.0) years (all participants)

Male/female 17/8

Male/female 16/9

Mean 6.1 (SD 2.2) weeks

Mean 6.3 (SD 2.5) weeks

Left/right 14/11

Left/right 14/11

Jaffe 2004

Mean 58.2 (SD 11.2) years (excluding dropouts)

Mean 63.2 (SD 8.3) years (excluding dropouts)

Male/female 5/5 (excluding dropouts)

Male/female 7/3 (excluding dropouts)

Mean 3.9 (SD 2.3) years (excluding dropouts)

Mean 3.6 (SD 2.6) years (excluding dropouts)

Left/right 6/4 (excluding dropouts)

Left/right 4/6 (excluding dropouts)

Kosak 2000

Mean 74 (SEM 2) years (all participants)

Mean 70 (SEM 2) years

Male/female 13/9

Male/female 18/16

Mean 39 (SEM 3) days

Mean 40 (SEM 4) days

Left/right/bilateral 8/12/2

Left/right/bilateral 12/16/6

Laufer 2001

Mean 66.6 (SD 7.2) years (excluding dropouts)

Mean 69.3 (SD 8.1) years (excluding dropouts)

Male/female 7/6

Male/female 7/5

Mean 32.6 (SD 21.2) days

Mean 35.8 (SD 17.3) days

Left/right 5/8

Left/right 5/7

Liston 2000

Mean 79.1 (SD 6.8) years (all EXP and CTL participants)

Male/female 12/6

Not reported

Not reported

Not reported

Not reported

Macko 2004

Mean 63 (SD 10) years

Mean 64 (SD 8) years

Male/female 22/10

Male/female 21/8

Mean 35 (SD 29) months

Mean 39 (SD 59) months

Left/right 18/14

Left/right 13/16

Nilsson 2001

Median 54 (range 24‐67) years (all participants)

Median 56 (range 24‐66) years

Male/female 20/16

Male/female 20/17

Median 22 (range 10‐56) days

Median 17 (range 8‐53) days

Left/right/bilateral 21/11/4

Left/right/bilateral 18/14/5

Pohl 2002

Mean 58.2 (SD 10.5) years for EXP 1 (excluding dropouts)
mean 57.1 (SD 13.9) years for EXP 2 (excluding dropouts)

Mean 61.6 (SD 10.6) years (excluding dropouts)

Male/female 16/4 for EXP 1
male/female 14/6 for EXP 2

Male/female 13/7

Mean 16.2 (SD 16.4) weeks for EXP 1
mean 16.8 (SD 20.5) weeks for EXP 2

Mean 16.1 (SD 18.5) weeks

Left/right 15/5 for EXP 1
left/right 16/4 for EXP 2

Left/right 16/4

Richards 1993

Mean 69.6 (SD 7.4) years (all participants)

Mean 67.3 (SD 11.2) years (CTL 1)

Male/female 5/5

Male/female 2/6

Mean 8.3 (SD 1.4) days

Mean 8.8 (SD 1.5) days

Left/right 8/2

Left/right 2/6

Scheidtmann 1999

Mean 57.7 (SD 11.0) years (all participants)

Male/female 16/14

Mean 52.2 (SD 29.6) days

Left/right 17/13

Visintin 1998

Mean 66.5 (SD 12.8) years (all participants)

Mean 66.7 (SD 10.1) years

Male/female 31/19

Male/female 28/22

Mean 68.1 (SD 26.5) days

Mean 78.4 (SD 30.0) days

Left/right 30/20

Left/right 21/29

Werner 2002a

Mean 59.7 (SD 10.2) years (all participants)

Mean 60.3 (SD 8.6) years (all participants)

Male/female 8/7

Male/female 5/10

Mean 7.4 (SD 2.0) weeks

Mean 6.9 (SD 2.1) weeks

Left/right 7/8

Left/right 7/8

Figures and Tables -
Table 1. Participant characteristics
Table 2. Dose of experimental interventions

Study ID

EXP ‐ treadmill

EXP ‐ support

EXP ‐ duration

EXP ‐ frequency

EXP ‐ N weeks

CTL ‐ intervent.

CTL ‐ duration

CTL ‐ frequency

CTL ‐ N weeks

Ada 2003

Gradually increased on an individual basis starting from 0.7 m/sec at the start of the first session and finishing at 1.1 m/sec at the end of the last session, on average

BWS ‐ no;
HAND SUPPORT ‐ yes, use of hand rails if required;
ASSISTANCE FROM THERAPIST ‐ only if required, 2 subjects needed slight help with stepping through for the first 2 weeks

30 minutes (24, 21, 18 and 15 minutes in treadmill training in the first, second, third and fourth training weeks, respectively)

3 times per week

4 weeks

Sham (task orientated home program with an intensity insufficient to produce an effect, plus telephone follow up once each week)

30 minutes

3 times per week (plus encouraged to walk every day)

4 weeks

da Cunha Filho 2002

Gradually increased in increments of 0.01 m/sec, starting at 0.01 m/sec

BWS ‐ yes, starting at 30% body weight and progressively decreased to 0%;
HAND SUPPORT ‐ not reported;
ASSISTANCE FROM THERAPIST ‐ not reported

20 minutes

5 times per week

2 to 3 weeks

Task orientated gait training

20 minutes

5 times per week

2 to 3 weeks

Dean 2000

Gradually increased on an individual basis

BWS ‐ no;
HAND SUPPORT ‐ not reported;
ASSISTANCE FROM THERAPIST ‐ not reported

60 minutes (5 minutes in treadmill training)

3 times per week

4 weeks

Sham (task oriented upper limb training)

60 minutes

3 times per week

4 weeks

Eich 2004

Speed and inclination increased on an individual basis to achieve a training heart rate.
Mean speed increased from 0.35 m/sec (SD 0.11) in week 1 to 0.64 m/sec (SD 0.15) in week 6.
In week 1 only 1/25 participants had an inclination of 4 degrees, this increased to 25/25 participants in week 6 with a mean inclination of 6.2 degrees

BWS ‐ yes, the harness was always secured and body weight was minimally supported (0 to 15%) according to participant need;
HAND SUPPORT ‐ not reported;
ASSISTANCE FROM THERAPIST ‐ yes, to set the paretic leg, weight shift and hip extension if required

30 minutes

5 times per week

6 weeks

Non‐task orientated (neurophysiological)

30 minutes

5 times per week

6 weeks

Jaffe 2004

Comfortable walking speed (speed not reported), speed was not progressed

BWS ‐ yes, harness used to prevent falls only;
HAND SUPPORT ‐ yes, use of hand rails if required;
ASSISTANCE FROM THERAPIST ‐ no

60 minutes

3 times per week

2 weeks

Task orientated (overground obstacle training)

60 minutes

3 times per week

2 weeks

Kosak 2000

Gradually increased from 0.22 to 0.89 m/sec, as tolerated

BWS ‐ yes, starting at 30% body weight and progressively decreased to 0% or eliminated;
HAND SUPPORT ‐ yes, use of hand rails if required;
ASSISTANCE FROM THERAPIST ‐ yes, assisted with swing phase, foot placement and weight shift if required

45 minutes

5 times per week

2 to 3 weeks

Non‐task orientated (orthopaedic)

45 minutes

5 times per week

2 to 3 weeks

Laufer 2001

Comfortable walking speed, speed used and progression not reported

BWS ‐ no;
HAND SUPPORT ‐ yes, use of hand rails if required;
ASSISTANCE FROM THERAPIST ‐ yes, assisted with swing phase and trunk alignment

8 to 20 minutes

5 times per week

3 weeks

Task orientated

8 to 20 minutes

5 times per week

3 weeks

Liston 2000

Speed used and progression not reported

BWS ‐ no;
HAND SUPPORT ‐ not reported;
ASSISTANCE FROM THERAPIST ‐ not reported

60 minutes

3 times per week

4 weeks

Task orientated

60 minutes

3 times per week

4 weeks

Macko 2004

Increased from a mean of 0.48 (SE 0.30) m/sec at baseline to 0.75 (SE 0.30) m/sec at treatment end on an individual basis to achieve a target aerobic intensity of 60‐70% heart rate reserve (treadmill slope increased from 0% at baseline to 2.2% (SE 2.2) at treatment end)

BWS ‐ no;
HAND SUPPORT ‐ yes, use of handrails if required;
ASSISTANCE FROM THERAPIST ‐ not reported

40 minutes (including 5 minutes warm up and 5 minutes cool down)
increased duration at target intensity from a mean of 12 (SE 6) minutes at baseline to 31 (SE 10) minutes at treatment end

3 times per week

6 months

Task orientated

40 minutes

3 times per week

6 months

Nilsson 2001

Gradually increased from 0.0 to 2.0 m/sec on an individual basis

BWS ‐ yes, starting at 100% body weight and decreased to 0%;
HAND SUPPORT ‐ yes, use of a cross bar if required;
ASSISTANCE FROM THERAPIST ‐ yes, assisted with swing phase, hip and knee extension during stance phase, and weight shift if required

30 minutes

5 times per week

9 to 10 weeks

Task orientated

30 minutes

5 times per week

9 to 10 weeks

Pohl 2002

Speed dependent treadmill training (EXP 1) ‐ aggressive increase in speed starting from the highest speed the participant could walk at without stumbling and increasing at 10% increments of this speed several times within a session. The average treadmill speed increased from 0.68 m/sec (SD 0.34) at the start of training to 2.05 m/sec (SD 0.71) at the end of training;
limited progressive treadmill training (EXP 2) ‐ gradually increased in increments of 5% of the initial maximum walking speed each week. The average treadmill speed increased from 0.66 m/sec (SD 0.39) at the start of training to 0.79 m/sec (SD 0.47) at the end of training

Speed dependent treadmill training:
BWS ‐ yes, no more than 10% body weight for the first 3 training sessions only (participants always wore an unweighted harness);
HAND SUPPORT ‐ not reported;
ASSISTANCE FROM THERAPIST ‐ no

Limited progressive treadmill training:
BWS ‐ yes, no more than 10% body weight for the first 3 training sessions only;
HAND SUPPORT ‐ not reported;
ASSISTANCE FROM THERAPIST ‐ yes, assisted with the walking cycle

30 minutes

3 times per week

4 weeks

Non‐task orientated (neurophysiological)

45 minutes

3 times per week

4 weeks

Richards 1993

Speed used and progression not reported

BWS ‐ no;
HAND SUPPORT ‐ not reported;
ASSISTANCE FROM THERAPIST ‐ not reported

105 minutes (about 35 minutes in TM training)

5 times per week

5 weeks

Non‐task orientated (neurophysiological)

105 minutes

5 times per week

5 weeks

Scheidtmann 1999

Gradually increased from 0.0 to 1.3 m/sec

BWS ‐ yes, amount of body weight support and progression not reported;
HAND SUPPORT ‐ yes, use of hand rails if required;
ASSISTANCE FROM THERAPIST ‐ yes, assisted with swing phase, foot placement, hip and knee extension during stance phase, and weight shift if required

30 minutes

5 times per week

3 weeks

Non‐task orientated (neurophysiological)

30 minutes

5 times per week

3 weeks

Visintin 1998

Gradually increased in increments of 0.04 m/sec, from 0.23 to 0.42 m/sec, on average, on an individual basis

BWS ‐ yes, starting at 40% body weight and progressively decreased to 0%;
HAND SUPPORT ‐ yes, use of hand rails if required;
ASSISTANCE FROM THERAPIST ‐ yes, assisted with stepping and limb control during stance and swing phases, and weight shift if required

20 minutes

4 times per week

6 weeks

Task orientated (treadmill only)
‐ gradually increased speed from 0.19 to 0.34 m/sec, on average, on an individual basis

20 minutes

4 times per week

6 weeks

Werner 2002a

Increased from a mean of 0.32 (SD 0.05) m/sec at baseline on an individual basis

BWS ‐ yes, starting at a mean of 8.93% (SD 1.84) body weight and progressively decreased;
HAND SUPPORT ‐ yes, use of handrails if required;
ASSISTANCE FROM THERAPIST ‐ yes, assisted with foot placement, swing phase, and hip and trunk extension during stance phase if required

15‐20 minutes

5 times per week

2 weeks

Task orientated

15‐20 minutes

5 times per week

2 weeks

Figures and Tables -
Table 2. Dose of experimental interventions
Table 3. Methodological quality and total PEDro score

Study ID (PED score)

Inclusion criteria

Random allocation

Concealed allocation

Baseline similar

Blinding

Dropouts

Intent‐to‐treat

Statistics

Mean & SD data

Ada 2003
(PEDro score 8/10)

Yes

Yes ‐ coin toss

Yes ‐ by ranking the participants according to independent walking speed at baseline (from fastest to slowest) and then allocating each descending pair of participants by coin toss

Yes

Participants ‐ no
Therapists ‐ no
Assessors ‐ yes

Yes ‐ 14% at end of treatment phase (and 10% at end of follow up)

Yes

Yes

Yes

da Cunha Filho 2002
(PEDro score 4/10)

Yes

Yes ‐ random number table

No

No

Participants ‐ no
Therapists ‐ no
Assessors ‐ no

Yes ‐ 13% at end of treatment phase (rating of this item was changed based on correspondence from the trialist)

No

Yes

Yes

Dean 2000
(PEDro score 6/10)

Yes

Yes ‐ by drawing a card from a box (there were 6 EXP and 6 CTL cards and they were not replaced after each draw)

Yes ‐ a person independent to the study drew the cards out of the box

Yes

Participants ‐ no
Therapists ‐ no
Assessors ‐ yes (however, may have been unmasked by inadvertently viewing 1 training session)

No ‐ 25% at end of treatment phase (33% at 2‐month follow up)

No

Yes

Yes

Eich 2000
(PEDro score 8/10)

Yes

Yes ‐ by an independent person asking the participant to draw an envelope from a box (each envelope contained the group allocation and there were 25 EXP and 25 CTL envelopes)

Yes ‐ sealed, opaque envelopes

Yes

Participants ‐ no
Therapists ‐ no
Assessors ‐ yes

Yes ‐ 0% at end of treatment phase (2% at 3‐month follow up)

Yes

Yes

Yes

Jaffe 2004
(PEDro score 7/10)

Yes

Yes ‐ using an Excel spreadsheet

Yes ‐ using an Excel spreadsheet with group allocation masked using black cells (rating of this item was changed based on correspondence from the trialist)

Yes

Participants ‐ no
Therapists ‐ no
Assessors ‐ yes (rating of this item was changed based on correspondence from the trialist)

Yes ‐ 15% at end of treatment phase (rating of this item was changed based on correspondence from the trialist)

No

Yes

Yes

Kosak 2000
(PEDro score 6/10)

Yes

Yes ‐ random number table

Yes ‐ a person independent to the study allocated participants after they were recruited (rating of this item was changed based on correspondence from the trialist)

Yes

Participants ‐ no
Therapists ‐ no
Assessors ‐ no

Yes ‐ 5% at end of treatment phase

No

Yes

Yes

Laufer 2001
(PEDro score 5/10)

Yes

No ‐ alternate assignment of participants to groups

No ‐ alternate assignment of participants to groups

Yes

Participants ‐ no
Therapists ‐ no
Assessors ‐ yes

Yes ‐ 14% at end of treatment phase

No

Yes

Yes

Liston 2000
(PEDro score 5/10)

Yes

Yes ‐ toss of a coin

No

No

Participants ‐ no
Therapists ‐ no
Assessors ‐ yes

No ‐ 17% at end of first treatment phase (rating of this item was changed based on correspondence from the trialist)

Yes

Yes

Yes

Macko 2004
(PEDro score 5/10)

Yes

Yes ‐ computer generated randomisation scheme which was stratified by walking speed (<0.44 m/sec and =>0.44 m/sec) and age (<65 years and =>65 years; method of randomisation was changed based on correspondence from the trialist)

No

Yes

Participants ‐ no
Therapists ‐ no
Assessors ‐ yes, for gait and balance outcomes (rating of this item was changed based on correspondence from the trialist)

No ‐ 26% at end of treatment phase

No

Yes

Yes

Nilsson 2001
(PEDro score 7/10)

Yes

Yes ‐ using a random number computer program by a person not involved in the trial

Yes ‐ sealed, opaque and consecutively numbered envelopes

Yes

Participants ‐ no
Therapists ‐ no
Assessors ‐ yes

Yes ‐ 10% at end of treatment phase (18% at 10 month follow up)

No

Yes

Yes

Pohl 2002
(PEDro score 7/10)

Yes

Yes ‐ stratified into groups of 3 based on walking time over 10m, then randomised to group by drawing an opaque envelope from a group of 3 (each envelope contained a piece of paper marked with one of the 3 experimental conditions)

Yes ‐ sealed, opaque envelopes that were not numbered (rating of this item was changed based on correspondence from the trialist)

Yes

Participants ‐ no
Therapists ‐ no
Assessors ‐ yes

Yes ‐ 13% at end of treatment phase

No

Yes

Yes

Richards 1993
(PEDro score 6/10)

Yes

Yes ‐ using a stratified block randomisation scheme

No

Yes

Participants ‐ no
therapists ‐ no
assessors ‐ yes

Yes ‐ 15% at end of treatment phase (number of dropouts not reported for 3 and 6 month follow ups)

No

Yes

Yes

Scheidtmann 1999
(PEDro score 4/10)

Yes

Yes ‐ method of randomisation not stated

No

No

Participants ‐ no
Therapists ‐ no
Assessors ‐ no

Yes ‐ 0% at end of first treatment phase

No

Yes

Yes

Visintin 1998
(PEDro score 6/10)

Yes

Yes ‐ using a stratified block randomisation scheme. Each block of 8 participants was generated by drawing cards (4 marked experimental and 4 marked control) from a box

Yes ‐ using sealed and numbered envelopes (rating of this item was changed based on correspondence from the trialist)

Yes

Participants ‐ no
Therapists ‐ no
Assessors ‐ yes

No ‐ 21% at end of treatment phase (48% at 3 month follow up)

No

Yes

Yes

Werner 2002a
(PEDro score 7/10)

Yes (rating of this item was changed based on correspondence from the trialist)

Yes ‐ by drawing an envelope from a box (there were 15 EXP then CTL order and 15 CTL then EXP order envelopes and they were not replaced after each draw)

Yes ‐ a person independent to the study drew the envelopes out of the box after recruitment

Yes

Participants ‐ no
Therapists ‐ no
Assessors ‐ yes

Yes ‐ 0% at end of first treatment phase (the number of dropouts was changed based on correspondence with the trialists)

No

Yes

Yes

Figures and Tables -
Table 3. Methodological quality and total PEDro score
Comparison 1. Treadmill and body weight support versus other interventions

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 dependence on personal assistance to walk at end of treatment phase Show forest plot

10

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 dependent in walking at start of treatment

5

178

Risk Ratio (M‐H, Fixed, 95% CI)

1.10 [0.90, 1.34]

1.2 independent in walking at start of treatment

5

147

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 walking speed (m/sec) at end of treatment phase Show forest plot

9

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 dependent in walking at start of treatment

4

148

Mean Difference (IV, Fixed, 95% CI)

‐0.01 [‐0.08, 0.06]

2.2 independent in walking at start of treatment

5

147

Mean Difference (IV, Fixed, 95% CI)

0.09 [‐0.02, 0.20]

3 walking endurance (m) at end of treatment phase Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

3.1 dependent in walking at start of treatment

2

69

Mean Difference (IV, Fixed, 95% CI)

‐2.45 [‐39.43, 34.52]

3.2 independent in walking at start of treatment

1

50

Mean Difference (IV, Fixed, 95% CI)

34.40 [‐7.42, 76.22]

4 dependence on personal assistance to walk at end of scheduled follow up Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4.1 dependent in walking at start of treatment

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 independent in walking at start of treatment

2

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 walking speed (m/sec) at end of scheduled follow up Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

5.1 dependent in walking at start of treatment

1

44

Mean Difference (IV, Fixed, 95% CI)

‐0.12 [‐0.37, 0.13]

5.2 independent in walking at start of treatment

2

65

Mean Difference (IV, Fixed, 95% CI)

0.11 [‐0.01, 0.24]

6 walking endurance (m) at end of scheduled follow up Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

6.1 dependent in walking at start of treatment

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.2 independent in walking at start of treatment

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 1. Treadmill and body weight support versus other interventions
Comparison 2. Treadmill only versus other interventions

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 walking speed (m/sec) at end of treatment phase Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

1.1 independent in walking at start of treatment

3

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 walking endurance (m) at end of treatment phase Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2.1 independent in walking at start of treatment

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 2. Treadmill only versus other interventions
Comparison 3. Treadmill and body weight support versus treadmill only

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 dependence on personal assistance to walk at end of treatment phase Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 dependent in walking at start of treatment

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 independent in walking at start of treatment

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 walking speed (m/sec) at end of treatment phase Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2.1 dependent in walking at start of treatment

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 independent in walking at start of treatment

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 walking endurance (m) at end of treatment phase Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 dependent in walking at start of treatment

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.2 independent in walking at start of treatment

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 dependence on personal assistance to walk at end of scheduled follow up Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4.1 dependent in walking at start of treatment

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 independent in walking at start of treatment

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 walking speed (m/sec) at end of scheduled follow up Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5.1 dependent in walking at start of treatment

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 independent in walking at start of treatment

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 walking endurance (m) at end of scheduled follow up Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

6.1 dependent in walking at start of treatment

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.2 independent in walking at start of treatment

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 3. Treadmill and body weight support versus treadmill only
Comparison 4. Treadmill and other task‐oriented exercise versus other interventions

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 dependence on personal assistance to walk at end of treatment phase Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 dependent in walking at start of treatment

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 independent in walking at start of treatment

2

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 unknown walking dependency at start of treatment

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 walking speed (m/sec) at end of treatment phase Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2.1 dependent in walking at start of treatment

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 independent in walking at start of treatment

2

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.3 unknown walking dependency at start of treatment

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 walking endurance (m) at end of treatment phase Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 dependent in walking at start of treatment

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.2 independent in walking at start of treatment

2

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.3 unknown walking dependency at start of treatment

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 dependence on personal assistance to walk at end of scheduled follow up Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4.1 dependent in walking at start of treatment

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.2 independent in walking at start of treatment

2

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

4.3 unknown walking dependency at start of treatment

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 walking speed (m/sec) at end of scheduled follow up Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5.1 dependent in walking at start of treatment

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 independent in walking at start of treatment

2

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 unknown walking dependency at start of treatment

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 walking endurance (m) at end of scheduled follow up Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

6.1 dependent in walking at start of treatment

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.2 independent in walking at start of treatment

2

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6.3 unknown walking dependency at start of treatment

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 4. Treadmill and other task‐oriented exercise versus other interventions
Comparison 5. Adverse events for all included trials

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Adverse events during the treatment phase Show forest plot

15

613

Risk Difference (M‐H, Random, 95% CI)

0.03 [‐0.01, 0.08]

Figures and Tables -
Comparison 5. Adverse events for all included trials
Comparison 6. Dropouts for all included trials

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Dropouts Show forest plot

15

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 by end of treatment phase

15

613

Risk Ratio (M‐H, Fixed, 95% CI)

0.80 [0.53, 1.19]

1.2 by end of scheduled follow up (cumulative)

7

305

Risk Ratio (M‐H, Fixed, 95% CI)

0.88 [0.61, 1.26]

Figures and Tables -
Comparison 6. Dropouts for all included trials
Comparison 7. First post‐hoc sensitivity analysis: all trials involving treadmill training

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Walking speed (m/sec) at end of treatment phase Show forest plot

15

428

Mean Difference (IV, Fixed, 95% CI)

0.03 [‐0.02, 0.09]

1.1 dependent in walking at start of treatment

4

148

Mean Difference (IV, Fixed, 95% CI)

‐0.01 [‐0.08, 0.06]

1.2 independent in walking at start of treatment

10

266

Mean Difference (IV, Fixed, 95% CI)

0.09 [0.01, 0.17]

1.3 unknown walking dependency at start of treatment

1

14

Mean Difference (IV, Fixed, 95% CI)

0.08 [‐0.75, 0.91]

Figures and Tables -
Comparison 7. First post‐hoc sensitivity analysis: all trials involving treadmill training
Comparison 8. Second post‐hoc sensitivity analysis: all trials involving body weight support

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 walking speed (m/sec) at end of treatment phase Show forest plot

11

374

Mean Difference (IV, Fixed, 95% CI)

0.06 [0.00, 0.11]

1.1 dependent in walking at start of treatment

5

207

Mean Difference (IV, Fixed, 95% CI)

0.04 [‐0.02, 0.10]

1.2 independent in walking at start of treatment

6

167

Mean Difference (IV, Fixed, 95% CI)

0.09 [‐0.01, 0.19]

Figures and Tables -
Comparison 8. Second post‐hoc sensitivity analysis: all trials involving body weight support
Comparison 9. Third post‐hoc sensitivity analysis: data reported by trialists

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 walking speed (m/sec) at end of treatment phase Show forest plot

15

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 all trials involving TM training

14

428

Mean Difference (IV, Fixed, 95% CI)

0.04 [‐0.01, 0.09]

1.2 all trials involving BWS

9

374

Mean Difference (IV, Fixed, 95% CI)

0.04 [‐0.00, 0.09]

Figures and Tables -
Comparison 9. Third post‐hoc sensitivity analysis: data reported by trialists