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

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Winstein 2004 (Continued)<br />

sive hydrocephalus; history of brain injury; severe aphasia, neglect, agitation or depression<br />

which could limit participation<br />

Interventions Intervention: upper limb movements resisted by gravity, free weights, Thera-Band and grip<br />

devices <strong>for</strong> fingers, 60 minutes/day 5 days per week <strong>for</strong> 4 to 6 weeks, high intensity <strong>for</strong> 3<br />

days per week and low intensity higher velocity <strong>for</strong> 2 days/week, <strong>training</strong> target 20 hours<br />

total<br />

Control: standard care delivered by occupational therapy, included muscle facilitation exercises<br />

using neuro-developmental approach, electrical stimulation, stretching, ADL and<br />

caregiver <strong>training</strong>; activities included use of upper limbs<br />

Setting: inpatient rehabilitation hospital and outpatient clinic<br />

Outcomes Included outcomes: FIM (mobility and self care scores); FTHUE; composite measure of<br />

strength (sum of torque from extension and flexion of the wrist elbow and shoulder); grip<br />

and pinch <strong>for</strong>ce<br />

Other outcomes: Fugl-Meyer scores<br />

Notes Change from baseline scores reported and analysed.<br />

Risk of bias<br />

Bias Authors’ judgement Support <strong>for</strong> judgement<br />

Allocation concealment (selection bias) Low risk Sealed envelopes<br />

Yang 2006<br />

Methods Design: randomised trial of mixed <strong>training</strong> versus no intervention - after usual care<br />

Randomisation mechanism: picking envelopes<br />

Allocation concealment: sealed envelopes<br />

Blinding: investigator<br />

Intention-to-treat: unknown<br />

Measurements: end of intervention (4 weeks)<br />

Withdrawals: none<br />

Participants Randomised: 48 participants<br />

Intervention: 24 participants; 16 males and 8 females; age 56.8 years (SD 10.2); time since<br />

<strong>stroke</strong> > 1 year<br />

Control: 24 participants; 18 males and 8 females; age 60 years (SD 10.4); time since <strong>stroke</strong><br />

> 1 year<br />

Inclusion criteria: first <strong>stroke</strong> < 1 year ago; not receiving rehabilitation; ambulatory, independent<br />

with no aids; medically stable to participate; able to understand instructions and<br />

follow commands<br />

Exclusion criteria: medical condition preventing participation; uncontrolled health condition<br />

<strong>for</strong> which exercise was contraindicated<br />

<strong>Physical</strong> <strong>fitness</strong> <strong>training</strong> <strong>for</strong> <strong>stroke</strong> <strong>patients</strong> (<strong>Review</strong>)<br />

Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.<br />

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