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

Flansbjer 2008
Methods Design: randomised trial of resistance training versus no training - after usual care
Randomisation: stratified unequal randomisation (2:1)
Allocation concealment: non-sealed envelopes
Blinding: physiotherapists who assessed isokinetic strength and gait performance outcomes
were blinded to group assignment but the physiotherapist who assessed dynamic strength
and muscle tone outcomes was not blinded; patient were not blinded but were told not to
disclose group assignment
Intention-to-treat: yes
Measurements: at the end of intervention (10 weeks) and 5-month follow-up
Withdrawals: 1 participant dropped out from the intervention group due to an accident
unrelated to strength training
Participants Randomised: total 25 participants
Intervention: 15 participants, 9 males and 6 females; mean age 61 (SD 5) years; time since
stroke 18.9 (SD 7.9) months
Control: 9 participants, 5 males and 4 females; mean age 60 (SD 5) years; time since stroke
20.0 (SD 11.6) months
Inclusion criteria: age 40 to 70 years; 6 months post-stroke; able to perform isolated extension
and flexion movements of the knee; at least 15% reduction in muscle strength in the
paretic limb (mean isokinetic peak torque at 60º/sec); walk unsupervised for 200 metres
with or without walking aid; no medication, physical, cognitive or mental dysfunction that
could impact upon knee muscle strength, gait performance or perceived participation; able
to understand verbal and written information
Exclusion criteria: not reported
Interventions Intervention group: 10 weeks of dynamic and isokinetic knee muscle strength training. Each
training session started with a warm-up of 5 minutes of stationary cycling, 5 repetitions
without resistance and 5 repetitions at 25% of maximum load. The participants then
performed 6 to 8 repetitions at about 80% of their maximum load with a 2-minute rest
between each set. The participants performed as many repetitions as possible. The load was
adjusted every two weeks to remain at 80% of their maximum load. Each training session
lasted about 90 minutes but the actual progressive strength training time was less than 6
minutes.
Control group: participants were encouraged to continue daily activities and training but
not to engage in any progressive strength training
Setting: community dwelling; training in hospital
Outcomes Included outcomes: dynamic and isokinetic muscle strength; 3-metre TUG; maximum
walking speed; 6MWT; SIS - Swedish version; muscle tone assessed with the mAS
Other outcomes: none
Notes Maximum walking speed data obtained from authors. The physiotherapist that supervised
the resistance training was the same that assessed dynamic strength and muscle tone outcomes
Risk of bias
Bias Authors’ judgement Support for judgement
Physical fitness training for stroke patients (Review)
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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