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. 2016 Dec 21;2016(12):CD011058. doi: 10.1002/14651858.CD011058.pub2

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
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
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
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
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