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

Duncan 2003
Methods Design: randomised trial of mixed training versus usual care - after usual care (outpatient)
Randomisation mechanism: unknown; method: blocks of 6
Allocation concealment: sealed envelopes
Blinding: investigator; participants asked to maintain blinding
Intention-to-treat: yes
Measurements: end of intervention (12/14 weeks) and 6-month follow-up
Withdrawals: intervention (10 participants: 6 before (1 renal insufficiency, 1 subclavian
steal syndrome, 1 chose withdrawal, 3 recurrent stroke) 4 after the 3-months follow up (1
died, 1 hospital, 2 recurrent stroke); control (11 participants: 2 before (1 withdrew, 1 nonreturn),
9 after 3-months follow-up (2 died, 2 hospital, 5 withdrew)
Participants Randomised: 100 participants
Intervention: 50 participants; 23 males and 27 females; age 68.5 years (SD 9.0); 77.5 days
post-stroke (SD 28.7)
Control: 50 participants; males and 27 females 23; age 70.2 years (SD 11.4); 73.5 days
post-stroke (SD 27.1)
Inclusion criteria: 30 to 150 days post-stroke; independent ambulation for 25 feet; Fugl-
Meyer scores 27 to 90; Orpington Prognostic Scale 2.0 to 5.2); Folstein Mini-Mental State
score 16
Exclusion criteria: serious cardiac condition; oxygen dependence; severe weight bearing
pain; serious organ system disease; life expectancy < 1 year
Interventions Intervention: mixed training, performed approximately 90 minutes per day 3 days per
week for 12 to 14 weeks (36 sessions); training included range of motion and flexibility,
strength training, balance, functional upper extremity practice, endurance training via
interval training on cycle ergometer. All elements progressive but intensity not quantified
Control: usual outpatient care including physiotherapy and occupational therapy for participants
who needed. All controls received 30-minute visit every 2 weeks including provision
of health promotion information
Setting: home-based, therapist-supervised for first 8 weeks
Outcomes Included outcomes: cognitive and motor subscales of the FIM; SF-36 subscales; ankle
dorsiflexion and knee extension isometric strength (Nm); isometric grip strength (N);
BBS; functional reach; VO2 peak; gait speed preferred (10-metre); 6MWT; community
ambulation (> 0.8 metres/second)
Other outcomes: Stroke Impact scale; cycle duration; Fugl Meyer scores
Notes Some outcomes reported as change from baseline scores. Others reported as means at end
of 6-month follow-up
Risk of bias
Bias Authors’ judgement Support for judgement
Allocation concealment (selection bias) Low risk Sealed envelopes
Physical fitness training for stroke patients (Review)
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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