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

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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. 49
Flansbjer 2008 (Continued) Allocation concealment (selection bias) High risk Non-sealed envelopes Glasser 1986 Methods Design: randomised trial of cardiorespiratory training plus % usual care versus usual care - during usual care Randomisation: unknown Allocation concealment: unknown Blinding: unknown Intention-to-treat: no withdrawals Measurements: end of intervention (10 weeks) Withdrawals: none Participants Randomised: 20 participants Intervention: 10 participants; 4 males and 6 females Control: 10 participants; 6 males and 4 females All participants age 40 to 75 years and were 3 to 6 months post-stroke; all participants exhibited hemiparesis with upper and lower extremity motor dysfunction; some showed sensory deficits and mild expressive or receptive aphasia Inclusion criteria: unknown Exclusion criteria: unknown Interventions Intervention: cardiorespiratory training: isokinetic ergometer (Kinetron) training twice a day 5 days per week for 10 weeks; the intensity was maintained at 50 to 100 psi and duration of each session progressed from 10 to 30 minutes over the first 5 weeks Control: therapeutic exercise and gait training 1 hour per session 2 sessions per day, 5 days per week for 5 weeks Setting: physical therapy department Outcomes Included outcomes: gait speed maximal (6 metres) Other outcomes: FAPS Notes Risk of bias Bias Authors’ judgement Support for judgement Allocation concealment (selection bias) Unclear risk Not reported Physical fitness training for stroke patients (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 50
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Physical fitness training for strok
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Analysis 1.19. Comparison 1 Cardior
Page 5 and 6: Analysis 5.10. Comparison 5 Mixed t
Page 7 and 8: Analysis 7.2. Comparison 7 Cardiore
Page 9 and 10: walking speed (mean difference (MD)
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Page 47 and 48: Bale 2008 Methods Design: randomise
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Page 79 and 80: mAS: modified Ashworth Scale MAS: M
Page 81 and 82: (Continued) Franceschini 2009 Not v
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Page 89 and 90: Ivey (B) Trial name or title Streng
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Page 93 and 94: Suskin 2007 (Continued) Time frame:
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21.2 After usual care 1 80 Mean Dif
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Analysis 1.2. Comparison 1 Cardiore
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Table 1. Outline of the studies whi
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Table 3. Outline of the studies whi
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Table 4. Pooled walking data for ca
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#42.(physical in Abstract and (exer
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71 8 and 36 and 70 72 limit 71 to h
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S58. (MH “Random Assignment”) o
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W H A T ’ S N E W Last assessed a
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MeSH check words Humans Physical fi
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