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

Moore 2010
Methods Design: randomised cross-over trial of cardiorespiratory training versus no intervention -
after usual care - (i.e. intensive locomotor training - including treadmill training - versus
delayed cardiovascular training)
Randomisation: stratified randomisation according to severity of gait impairment
Allocation concealment: sealed envelopes
Blinding: investigators were not blinded
Intention-to-treat: not reported
Measurements: end of intervention (4 weeks)
Withdrawals: none reported
Participants Randomised: 20 participants; mean age 50 years (SD 15); males 14, females 6; duration of
post-stroke symptoms 13 months (SD 8); moderate/severe gait limitations 13/7
Intervention: the number of participants randomised to the immediate locomotor training
group was not clearly reported
Control: the number of participants randomised to the delayed locomotor training group
was not clearly reported
Inclusion criteria: patients with hemiparesis of > 6 months duration who were attending
physical therapy after unilateral supratentorial stroke; all patients were required to walk >
10 metres overground without physical assistance and medical clearance
Exclusion criteria: lower extremity contractures; significant osteoporosis; cardiovascular
instability; previous history of peripheral or central nervous system injury, cognitive or
communication impairment; inability to adhere to study requirements
Interventions Intervention: the immediate locomotor training group received 4 weeks of intensive locomotor
training after discharge from clinical physical therapy, which consisted of high
intensity stepping practice on a motorized treadmill while wearing an overhead harness
attached to a safety system. Frequency: 2 to 5 days per week for 4 weeks. Intensity: highest
tolerable speed with velocity increased in 0.5 kmph increments until participants reached
80% to 85% of predicted maximum heart rate or until the participants Rating of Perceived
Exertion increased to 17 on the Borg scale. Partial weighted support was reduced in 10%
increments as tolerated by participants who needed partial weighted support. Measurements
were performed: 4 weeks before termination of usual physical therapy; soon after
termination of usual physical therapy; after completion of the 4-week locomotor training;
and again after a delay of 4 weeks after termination of locomotor training
Control: delayed locomotor training group. The delayed group was also assessed 4 weeks
before and after termination of usual physical therapy, but did not receive locomotor
training or any other interventions for 4 weeks after termination of usual physical therapy.
After this 4 week delay the participants received locomotor training as described above
Setting: rehabilitation centre
Outcomes Included outcomes: preferred gait speed; fastest gait speed; 12MWT; O2 cost; peak treadmill
speed; VO2 peak, TUG; BBS
Notes Only data at the end of the first cross-over period were used for analyses
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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