Even the meta-analyses of walking speed

and capacity, which were carried out only on those who could walk, included numbers ranging from 88 to 172. Meta-analysis indicated that, on average, 23% more patients (ie, 55% of participants in the experimental group compared with 32% of participants in the control group) could walk after Selleck Navitoclax 4 weeks of mechanically assisted walking with body weight support than could walk after assisted overground walking, ie, it decreased dependence for those patients who were non-ambulatory a few weeks after stroke. In addition, there were sufficient data from two trials to examine whether this benefit was maintained. At 6 months, there were still 24% more people (ie, 70% of participants in an experimental group compared with 46% of participants in a control group) walking having received mechanically assisted walking as an inpatient compared with those having received overground walking. Even though there was statistical heterogeneity between these selleck studies suggesting caution, it is encouraging that the mean benefit was almost the same when a random effects model was applied (23% more patients walking) and was also the same as it had been at 4 weeks when 539 participants were pooled over six studies. One hypothesis for the increase in independent walking with mechanically assisted walking is that this intervention provides the

opportunity to complete more whole task walking practice than would be

possible with overground walking alone. The allowable amount to of time spent on walking was the same for the control group as the experimental group in all the studies. However, three studies report more distance covered or steps taken by the group receiving mechanically assisted walking than the group receiving assisted overground walking. Ada et al (2010) report that in Week 1 the average distance walked per session by the control group was only 20% of the experimental group and in the last week the distance was still less than 50%. Similarly, Pohl et al (2007) report that the average steps taken per session by the control group was less than 20% of the experimental group, and Tong et al (2006) report that the steps taken per session by the control group were 10% of the experimental group. Therefore, for a similar therapy time, more walking was carried out. Given the evidence from a systematic review of randomised trials that outcome after stroke is associated with the amount of practice undertaken (Kwakkel et al 2004), the extra walking carried out during the same therapy time probably explains why more patients receiving mechanically assisted walking walked independently than those receiving assisted overground walking. Meta-analysis revealed that mechanically assisted walking resulted in more walking without compromising the walking itself.