Table 4.

Effect of intensive mobility training on walking (studies ordered chronologically).

Author	Subjects	Group Assignment	Mobility Program description	Results
Early post-stroke (within 6 months)
Duncan et al. [84] 1998	N=20 Stroke within 30–90 days Ambulatory with supervision, mild to moderate impairment (Fugl-Meyer Motor score 40–90).	Group 1 (n=10): Mobility, IP=1:1 12 weeks (8 week supervised and 4 week unsupervised) at home Group 2 (n=10): Control (Usual care)	Assisted and resisted exercises with theraband Functional exercises Balance exercises Progressive walking program or bicycle ergometer	No group difference for 6MWT but trend for gait speed (0.1>p>,05)
Duncan et al. [85] 2003	N=92 Stroke within 30–150 days Able to walk 25 ft independently	Group 1 (n=44): Mobility, 36 sessions, 90 min, IP=1:1 over 12–14 weeks at home Group 2 (n=48): Control (Usual care)	Strengthening using theraband Balance: step up and sideways onto a step, chair rise, fall back against wall while standing and bounce upright, marching, rise on toes, kicking ball, simulated golfing/batting, stops and turns while walking Arm and hand use in real-life tasks (washing counters, putting away dishes, folding towels) Stationary bike up to 30 min with increasing speed and resistance	Gait speed*: Mobility+ 26%, Control +18% (ES=0.23) 6MWT*: Mobility +40%, Control +15% No group difference for TUG
Blennerhasset and Dite [86] 2004	N=30 Stroke inpatients, mean 36 days since stroke Able to walk 10 m with close supervision, independent ambulators were excluded	4 weeks, 1 hour, 5 day/week, IP=1:4 in addition to standard therapy in medical center Group 1 (n=15): Mobility Control Group (n=15): Arm exercises (strengthening, reaching, stretching)	10 stations (5 min each): stationary bikes, treadmills, sit-to-stand, step-ups, obstacle course, standing balance, stretching, strengthening using gym equipment	6MWT*: Mobility + 121%, Control +59% TUG*: Mobility −52%, Control +18%
6 months post-stroke or later
Dean et al. [87] 2000	N=12 Community dwelling, > 3 months post-stroke Walk 10 m independently	4 weeks, 1 hour, 3X/week, IP=2:5 in medical center Group 1 (n=6): Mobility Group 2 (n=6): Control Group Upper extremity program	10 stations (5 min each): sit at table and reach, rise from chair of different heights, step in different directions to blocks of different heights, rise on toes, standing and reaching (including to floor), Kinetron for resisted leg flexion/extension, rise from chair and walk, walk on treadmill, walk on different surfaces, walk on different slopes and stairs, walking relays	Gait speed without device* Mobility+ 22%, Control +0.1% 6MWT*: Mobility + 20%, Control +0.7% No group difference for TUG or gait speed with device
Chu et al. [88] 2004	N=12 > 1 year post-stroke Independent in walking, able to reach 60% of age-predicted heart rate on cycle ergometer	8 weeks, 1 hour, 3 day/week, IP=1:3 to 1:5 Group 1: (n=7): Mobility in community pool Group 2: (n=5): Control arm exercise	Shallow water walking, running, hopping, side stepping, marching, single leg and double-leg hops with graded aerobic component from 50–80% heart rate reserve. Resistance provided by water.	Gait speed*: Mobility +19%, Control + 3%
Salbach et al. [89,122] 2004, 2005	N=91 Community dwelling, within 1 year post-stroke (mean about 7–8 months) Walk 10 m independently with or without supervision	6 weeks, 1 hour, 3X/week in medical center Group 1 (n=44): Mobility, IP=1:1 Group 2 (n=47): Control Upper extremity program	10 tasks (5 min each, except 10 min treadmill): step-up, walking on narrow line (forward, backward, sideways), kicking and dribbling ball, stand up and walk, treadmill with increasing speed and inclination, walking and carrying, continuous walking with progression to running, walking backwards, going up and down stairs	6MWT*: Mobility+19%, Control+2% Gait speed*: Mobility+22%, Control+5% TUG*: Mobility−29%, Control−10%
Marigold et al. [90] 2005	N=61 Community dwelling, > 1 year post-stroke Walk 10 m independently	10 weeks, 1 hour, 3X/week, IP=1:3 in community setting Group 1(n=30): Mobility Agility program Group 2 (n=31): Control Weight-bearing and stretching	Agility tasks: weight-shifting, varying step lengths and speeds, tandem walking, figure of 8 walk, alternate stepping on low rises, crossover stepping, repetitive sit-to-stand, knee raises while standing, standing perturbations. Eyes closed and foam surfaces were used for some of the tasks.	TUG*: Mobility −17%, Control − 8%* Induced falls on translating platform*: Mobility group reduced falls, while Control increased falls. Falls in community*: For those with history of falls, Mobility subjects had less falls in the 1 year following study than Control subjects.
Pang et al. [91] 2005	N=63 Community dwelling, > 1 year post-stroke Walk 10 m independently Able to raise heart rate to 60% of age-predicted max with a leg cycle ergometer	5 months, 1 hour, 3X/week, IP=1:4 in community setting Group 1 (n=32): Mobility and fitness Group 2 (n=31): Control, Seated arm program	Brisk walking, sit-to-stand, alternate stepping on low rises (increment from 40–70% heart rate reserve) Mobility tasks: walking in different directions, tandem walking, obstacle course, sudden stops and turns, walking on different surfaces, standing on foam, kicking a ball Functional strengthening: partial squats, rising on toes	6MWT*: Mobility+20%, Control+13%
Yang et al. [92] 2006	N=48 Community dwelling, > 1 year post-stroke Walk 10 m independently	Group 1 (n=24): Mobility (task-oriented progressive resisted program), 4 weeks, 30 min, 3X/week, IP=1:1, in medical center Group 2 (n=24): Control with no treatment	6 stations (5 min each): 1. standing and reaching, 2. rising from chair of different heights, 3. step forward/backward onto blocks, 4. step sideways, onto blocks, 5. step up onto blocks, 6. rise on toes	6MWT*: Mobility+12%, Control+2% Gait speed*: Mobility+10%, Control−0.2 TUG*: Mobility +12%, Control + 0.7%
Olney et al. [93] 2006	N=72 Chronic stroke (mean 3–4 years post-stroke) Able to walk 15 min with rests	Group 1 (n=37): Supervised: 10 weeks, 1.5 hour, 3 day/week, IP=1:4 in community setting Group 2 (n=35): Unsupervised: 3 supervised sessions followed by 9 week unsupervised home program	Graded walking program (50–70% age-adjusted heart rate max) Strength training (theraband, simple weights, functional exercises)	6MWT: Supervised+12%, Unsupervised+14% (No group difference)

+/− % indicates percent increase or decrease from baseline.

^*indicates significant comparison reported in study. IP=Instructor:Participant ratio