Dean 2000.

Study characteristics
Methods	Study design: RCT Method of randomisation: After baseline measurement, participants were grouped into matched pairs according to their average gait speed. Participants in each pair were randomly assigned to experimental or control group, using an independent person to draw cards from boxes
Participants	Number of participants: n = 12 Inclusion criteria: first stroke, more than three months post stroke, discharged from rehabilitation, able to attend rehabilitation centre three times a week for four weeks and able to walk 10 m independently Exclusion criteria: any medical condition that would prevent participation in a training programme
Interventions	(1) Motor learning group (n = 6) Standardised circuit programme designed to strengthen the muscles in the affected leg in a functionally relevant way and provide for practice of locomotor‐related tasks "For the experimental group, the exercise class was designed as a circuit program, with subjects completing practice at a series of work stations as well as participating in walking races and relays with other members of the group. The workstations were designed to strengthen the muscles in the affected leg in a functionally relevant way and provide for practice of locomotor related tasks. The 10 workstations incorporated into the circuit were: (1) sitting at a table and reaching in different directions for objects located beyond arm’s length to promote loading of the affected leg and activation of affected leg muscles; (2) sit‐to‐stand from various chair heights to strengthen the affected leg extensor muscles and practice this task; (3) stepping forward, backward, and sideways onto blocks of various heights to strengthen the affected leg muscles; (4) heel lifts in standing to strengthen the affected plantarflexor muscles; (5) standing with the base of support constrained, with feet in parallel and tandem conditions reaching for objects, including down to the floor, to improve standing balance; (6) reciprocal leg flexion and extension using the Kinetron in standing to strengthen leg muscles; (7) standing up from a chair, walking a short distance, and returning to the chair to promote a smooth transition between the two tasks; the remaining stations (8) walking on a treadmill; (9) walking over various surfaces and obstacles and (10) walking over slopes and stairs provided the opportunity for practice of walking under variant conditions" The individual components delivered are listed in Table 6. Based on the individual components, this intervention is categorised as comprising functional task training and musculoskeletal intervention (active) Length of intervention period: four weeks Number of sessions and length of individual sessions: one‐hour programme, three days/wk Intervention provider: "All training sessions were organized into a group exercise class, conducted by the one of the investigators who was assisted by another physiotherapist" (2) Placebo group (n = 6) Standardised circuit programme designed to improve function of the upper limb The individual components delivered are listed in Table 6. Based on the individual components, this intervention is categorised as comprising attention control (upper limb) Length of intervention period: four weeks Number of sessions and length of individual sessions: one‐hour programme, three days/wk Intervention provider: "All training sessions were organized into a group exercise class, conducted by the one of the investigators who was assisted by another physiotherapist" This study was classified as intervention (functional task training, musculoskeletal (active)) versus attention control (upper limb) (Table 8)
Outcomes	Measures of voluntary movement: timed 10‐Metre Walk; Six‐Minute Walk test; Step test; Timed Up and Go test; laboratory gait assessment Other measures: strength and dexterity of the upper limb Time points when outcomes were assessed: "Subjects were evaluated three times: before the training (pretraining), at the end of the training (posttraining), and 2 months later (follow‐up)"
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	After baseline measurement, participants were grouped into matched pairs according to their average gait speed. Participants in each pair were randomly assigned to experimental or control group, using an independent person to draw cards from boxes
Allocation concealment (selection bias)	Unclear risk	Although participants were paired according to average gait speed, it is not clear how this matching was performed; if the person doing the matching was not blind to the other characteristics of the participants, there is the potential for selection bias
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	The assessor was blinded for all assessments except one (Six‐Minute Walk test)
Incomplete outcome data (attrition bias) All outcomes	Low risk	Dropouts accounted for Nine of 12 completed training and pretraining and post‐training assessments Eight of 12 completed follow‐up (two‐month) assessment
Free of systematic differences in baseline characteristics of groups compared?	Low risk	"Subjects completed the pretraining evaluation and were then grouped into matched pairs according to the average walking speed at the pretraining evaluation"
Did authors adjust for baseline differences in their analyses?	Low risk	No information provided
Other bias	High risk	The same therapist conducted the training sessions for both groups and was responsible for progression of treatment, etc; this may potentially contaminate the groups The study included only participants who were able to travel to the rehabilitation centre and prepared to meet the costs of this. The results of this study therefore can be applied only to equally motivated participants