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

Langhammer 2007
Methods Design: randomised trial of mixed training versus usual care - after usual care - i.e. intensive
exercise (with emphasis on endurance, strength and balance) versus regular exercise (no
specific treatment was recommended) at discharge. Sample size calculation reported
Randomisation: stratified randomisation according to gender and hemisphere lesion (minimisation).
Method of randomisation: dice (uneven numbers versus even numbers). Randomisation
was performed by an investigator not involved with the patients or the treatment
Allocation concealment: unclear. protocol was sealed for 1.5 years from the start of the
study
Blinding procedure: outcome assessor blinded
Intention-to-treat: planned but not performed
Measurements: 3, 6, and 12 months
Withdrawals: 3 participants in the intensive group at discharge (1 dead and 2 withdrawals)
and 5 (3 dead and 2 withdrawals) in the regular exercise group at discharge. 1 dead and 1
withdrawal at 3 months and 2 dead at 6 months in the regular exercise group
Participants Randomised: 75 participants
Intervention: 35 participants, gender not reported; mean age 76 years (SD 12.7)
Control: 40 participants, gender not reported; mean age 72 years (SD 13.6)
Inclusion criteria: first-time stroke, confirmed by CT and voluntary participation
Exclusion criteria: more than one stroke event, subarachnoid bleeding, tumour, other serious
illness, brainstem or cerebellar stroke
Interventions Intervention: intensive individualised training programme supervised by physiotherapists.
Endurance = walking indoors and outdoors, stationary bicycling, stair walking, treadmill,
etc, at 70% to 80% maximal pulse. Strength = push-ups, sit-ups, weight lifting, pulley, etc,
at 50% to 60% calculated from 1 repetition maximum. Patients were also encouraged to
maintain high activity level apart from that in the training sessions. Frequency: 2/3 times
per week (daily in rehabilitation ward); minimum 20 hours every third month, in the first
year after stroke
Control: rehabilitation and follow-up treatments according to participants’ needs but not
on regular basis. No specific treatment was recommended. Participants were however encouraged
to maintain high activity level
Setting: general hospital, patients homes and community service centres
Outcomes Included outcomes: MAS; BI; grip strength measured with a Martin Vigorimeter; occurrences
of falls and pain
Other outcomes: none
Notes
Risk of bias
Bias Authors’ judgement Support for judgement
Allocation concealment (selection bias) Unclear risk Unclear; protocol was sealed for 1.5 years
from the start of the study
Physical fitness training for stroke patients (Review)
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
55