Wall 1987.
Methods |
Design: randomised trial about exercise therapy; 4 groups: home exercise programme alone, outpatient physiotherapy alone, home exercises + physiotherapy, no intervention Study duration: 9 months (6 months' intervention, 3 months' follow‐up) Randomisation: 'randomly assigned' is stated in article. No further information Allocation concealment: not described Blinding: not described ITT: yes, no withdrawals |
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Participants |
Randomised: 20 participants Withdrawals: 0 Intervention and control: 4 interventions; 5 participants per intervention; no information about participants per intervention; in general: aged 45 to 70 years; men and women; time since stroke between 18 months and 10 years Inclusion criteria: not clearly stated (capable of walking with or without a walking stick) Exclusion criteria: negative prognosticators such as serious or unstable medical conditions, major central sensory disorders, homonymous hemianopia, marked cognitive disturbances, intractable pain, motivation defects, incontinence of bowel or bladder |
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Interventions |
Intervention: Group B: home exercise programme: 10 exercises over 1 hour. They were designed hierarchically in terms of complexion. Each exercise lasted 5 minutes with the same distribution of exercise and rest. After the fifth and the eighth exercise there was a 5‐minute rest. After 1 month, the most basic exercise was dropped and an additional, more demanding, exercise was added. The exercises were done twice a week. A booklet describing the exercises, duration, and sequence was provided. The programme was undertaken in the person's home with supervision of their spouse or companion. Twice a week for 1 hour. The physiotherapist monitored the programme. Instructional videotapes were available to demonstrate the correct way to do the exercise. These were shown to patients and caregivers when they came for assessment. Group C: outpatient physiotherapy + home exercise programme: exercise programme (as Group B); once a week for 1 hour outpatient physiotherapy and once a week for 1 hour home exercise programme. Control: Group A: outpatient physiotherapy alone; the exercises were taught by a physiotherapist. Feedback and correction was given by this therapist. Twice a week for 1 hour. Group D: control group: no therapy Setting: outpatient |
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Outcomes |
Included outcomes: walking speed Other outcomes: measurements of duration of the single support phase of the affected side, measures of the degree of temporal symmetry; asymmetry ratio Measurements: baseline assessment, 1 month interval during treatment, after treatment, and follow‐up after 3 months |
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Notes | Inclusion criteria were not clearly stated. There was information about the participants: all participants had residual hemiplegia due to stroke experienced between 18 months and 10 years previously. They all had undergone rehabilitation and were discharged from this. All participants were capable of walking and showed (subjectively) a reduced support phased time of the affected limb. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | "Randomly assigned", but not stated how. |
Allocation concealment (selection bias) | Unclear risk | Not described |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and personnel cannot be blind for the intervention. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Not described |
Incomplete outcome data (attrition bias) All outcomes | Low risk | No withdrawals |
Selective reporting (reporting bias) | Unclear risk | No trial registry; nothing stated |
Other bias | Low risk |