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. 2013 Jul 25;2013(7):CD006185. doi: 10.1002/14651858.CD006185.pub3

Werner 2002

Methods Cross‐over RCT Method of randomisation: participants randomly assigned to groups (group allocation in envelopes that were drawn by an independent person) Blinding of outcome assessors: yes Adverse events: none Deaths: none Drop‐outs: none ITT: yes
Participants Country: Germany 30 participants (15 in treatment group, 15 in control group) Non‐ambulatory at study onset Mean age: 60 years Inclusion criteria: first stroke, supratentorial lesion 4 to 12 weeks post‐stroke, younger than 75 years of age, not able to walk (Functional Ambulation Category of 2 or less), able to sit unsupported on the edge of a bed, able to stand for at least 10 seconds with help, able to provide and did provide written informed consent Exclusion criteria: hip and knee extension deficit > 20 degrees; passive dorsiflexion of the affected ankle to less than a neutral position; severe impairment of cognition or communication; evidence of cardiac ischaemia, arrhythmia, decompression or heart failure; feeling of 'overexertion' or heart rate exceeding the age‐predicted maximum (i.e. 190 beats/minute minus age) during training; resting systolic blood pressure exceeding 200 mm Hg at rest or dropping by more than 10 mm Hg with increasing workload
Interventions 2 arms:
  • 2 weeks A, 2 weeks B, 2 weeks A

  • 2 weeks B, 2 weeks A, 2 weeks B


Treated as inpatients for 5 15‐ to 20‐minute sessions per week for 2 weeks A: treadmill training with body weight support: participants walked on a treadmill with partial body weight support provided by a harness B: gait trainer with body weight support: participants walked on a Gait Trainer with partial body weight support provided by a harness
Outcomes Outcomes were recorded at baseline and after 2 weeks (additionally after 4 and 6 weeks, but only the first phase was included in this review):
  • Functional Ambulation Category

  • Fast walking speed over 10 metres with personal assistance and gait aids if required

  • Rivermead Motor Assessment Scale

  • Ankle spasticity (modified Ashworth Scale)

Notes We used the first treatment phase only Published and unpublished data provided by the authors 0% drop‐outs at the end of first treatment phase (data were analysed as ITT)
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk By envelopes
Allocation concealment (selection bias) Low risk Concealed envelopes that were drawn by an independent person
Blinding of outcome assessment (detection bias) All outcomes Low risk Yes
Incomplete outcome data (attrition bias) All outcomes Low risk No missing data