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

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Richards 2004 (Continued) achieved via velocity and resistance (Kinetron) increments Control: physiotherapy sessions of 60 minutes per day 5 days per week for 8 weeks not including the task-oriented gait training content above Setting: 2 rehabilitation units Outcomes Included outcomes: preferred walking speed; TUG; BI (ambulation subscore); BBS Other outcomes: kinematic gait analysis weakened by missing data in 50% participants; Fugl-Meyer leg and arm scores Notes A second control group of conventional therapy was not used for comparison since (1) it was much shorter in duration, and (2) started later than the training intervention. Outcome data imputed from graphs in publication Risk of bias Bias Authors’ judgement Support for judgement Allocation concealment (selection bias) Unclear risk Not reported Salbach 2004 Methods Design: randomised trial of cardiorespiratory training versus non-exercise intervention - after usual care Randomisation mechanism: computer; method: stratified on gait speed Allocation concealment: unknown Blinding: investigator blinded (unblinded during assessment of intervention group 18/42 and control group 16/43) Intention-to-treat: yes Measurements: end of intervention (6 weeks) Withdrawals: intervention: 3 discontinued (refused to travel, wanted both interventions, groin pain) with 2 of these lost to follow-up; control: 4 discontinued (MI, prostate cancer, fall + fracture, wanted other intervention) with 3 of these lost to follow-up Participants Randomised: 91 participants Intervention: 44 participants; 26 males and 18 females; age 71 years (SD 12); 239 days post-stroke (SD 83) Control: 47 participants; 30 males and 17 females; age 73 years (SD 8); 217 days poststroke (SD 73) Inclusion criteria: first or recurrent stroke; gait deficit from recent stroke; mental competency; independently ambulatory for 10-metres +/- aids or supervision; ability to comprehend instructions; resident in community; discharged from rehabilitation; recent stroke 1 year or less Exclusion criteria: neurological deficit caused by metastatic disease; gait function (6MWT) equivalent to healthy norms; discharged to permanent care; comorbidity preventing participation in either intervention Physical fitness training for stroke patients (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 65
Salbach 2004 (Continued) Interventions Intervention: cardiorespiratory training: task-oriented circuit training, performed 55 minutes per day 3 days per week for 6 weeks, comprising a warm up followed by 10 walkingrelated tasks (step ups, balance beam, kicking ball, stand up and walk, obstacle course, treadmill, walk and carry, speed walk, backward walking, stairs); progression of speed, load and degree of assistance Control: functional practice, whilst seated, of writing, keyboard use, and manipulating cards; some practice encouraged at home Setting: 2 rehabilitation centres or hospitals Outcomes Included outcomes: gait endurance 6MWT; gait comfortable speed; gait maximal speed; TUG; BBS Other outcomes: activity-specific balance confidence scale Notes Risk of bias Bias Authors’ judgement Support for judgement Allocation concealment (selection bias) Unclear risk Not reported Sims 2009 Methods Design: pilot randomised study of resistance training versus no intervention (i.e. a waitinglist comparison group) - after usual care. Sample size calculation reported Randomisation: computer generated block randomisation by an independent investigator - blocks of 6 stratified by gender Allocation concealment: unclear Blinding:unclear Intention-to-treat: yes Measurements: at the end of the training programme (10 weeks) and at 6-month followup Withdrawals: 1 participant did not complete the 10-week assessment; 5 participants (3 intervention, 2 control) did not complete the physical assessment at 10 weeks due to health reasons unrelated to the programme or time commitments. 43 participants completed the 6-month survey assessment Participants Randomised: 45 participants; 27 males and 18 females; mean age 67.13 years (SD 15.23) , average time since stroke 13.2 months (SD 4.95) Intervention: 23 participants were allocated to the progressive resistance training group. 21 participants completed the 10-week programme (2 people became medically ineligible) Control: 22 participants were allocated to the waiting-list control group Inclusion criteria: stroke survivors with depressive symptoms Exclusion criteria: under 18 years; stroke < 6 months ago; inability to walk a distance of at least 20 metres independently with or without a gait assistive device; Prime-MD Patients Health Questionnaire (PHQ-9) score < 5; depression with psychotic features; alcohol or drug-related depression, schizophrenia; bipolar disorder; other psychiatric diagnoses; suicidal ideation; dementia; terminally ill; uncontrolled hypertension; unstable angina; and Physical fitness training for stroke patients (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 66
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Physical fitness training for strok
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Analysis 1.19. Comparison 1 Cardior
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Analysis 5.10. Comparison 5 Mixed t
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Analysis 7.2. Comparison 7 Cardiore
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walking speed (mean difference (MD)
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Post-stroke physical activity and f
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Search methods for identification o
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• type of training (cardiorespira
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Compliance with the scheduled exerc
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Case fatality Number of deaths was
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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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