Physical fitness training for stroke patients (Review) - Update Software

Bale 2008
Methods Design: randomised trial of resistance training plus % usual care versus usual care - during
usual care. Sample size calculation reported
Randomisation: drawing lots - not clearly described
Allocation concealment: unclear
Blinding: outcome assessors blinded
Intention-to-treat: planned but no withdrawals
Measurements: at the end of intervention (4 weeks)
Withdrawals: none
Participants Randomised:18 participants
Intervention: 8 participants; 3 males and 5 females; mean age 68.0 years (SD 13); time
since stroke 49.4 (SD 22.1) days
Control:10 participants 4 males and 6 females; mean age 64.9 years (SD 8.8); time since
stroke 32.0 (SD 18.5) days
Inclusion criteria: first onset of stroke with reduced muscle strength in the affected leg;
ability to understand verbal information; ability to sit without support
Exclusion criteria: significant sensory or cognitive sequels; arrhythmia; uncontrolled angina
pectoris or hypertension; co-morbidities that could mask the sequels from the stroke; lack
of motor control of the affected leg
Interventions Intervention group: resistance training 50 minutes a day 3 days per week for 4 weeks. 8
individually tailored exercises for the affected lower limb involving weight bearing, stepping,
sit-to-stand, heel/toe raising, and bridging. Tailored progression included using weights,
reducing speed, adding more sets, etc. Other functional activities sometimes included too
(walking, stair climbing, sit-to-stand). One set of 10 to 15 repetitions to moderate fatigue
Control group: usual care (Bobath) 50 minutes a day 3 days per week for 4 weeks, plus
usual care (other) 50 minutes/day, 2 days per week for 4 weeks. Total training: 50 minutes
a day 5 days per week for 4 weeks
Setting: 2 rehabilitation units
Outcomes Included outcomes: isometric muscle strength; preferred walking speed; maximal walking
speed
Other outcomes: maximum weight bearing; 2 items of the MAS; Patient Global Impression
of Change tool
Notes Very small sample size
Poor external validity
Risk of bias
Bias Authors’ judgement Support for judgement
Allocation concealment (selection bias) Unclear risk Poorly reported
Physical fitness training for stroke patients (Review)
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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