Liao 2006.
Study characteristics | ||
Methods | Study design: RCT Method of randomisation: participants randomly divided into the two groups by the time of hospital admission |
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Participants | Number of participants: n = 96 Inclusion criteria: "(1) Satisfied the 1995 Fourth National Conference on Cerebral Vascular Disease classification guidelines, confirmed by CT or MRI scan for the first ever stroke, (2) deficits in motor function, without any serious cognitive impairment, (3) aged between 40 to 80, no severe heart, liver, kidney or other organ diseases, (4) Glasgow Coma Scale > 8, medically stable within 1 week" |
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Interventions | (1) Treatment group (n = 48) "Both groups of patients were treated with conventional medicine to reduce oedema in brain, nourish brain and nervous system, improve blood circulation in brain, etc, treatment group besides conventional rehabilitation also received trunk control function training therapy" "Conventional rehabilitation method: (i) regular change in body positioning and maintaining limbs in correct positions; (ii) Passive ranging exercises on affected limbs; (iii) Facilitative training of affected limbs; (iv) Bedside sitting‐balance training: affected upper limb maintained in anti‐spasticity position to prop against the bed and progressing from sitting with support to sitting without support, and by repeatedly training the patient to use head and trunk to shift towards the centre, sitting‐balance was induced; (v) Sit to stand balance training: Patient clasped hands Bobath style, extended upper limbs, leaned head and trunk forward, placed both feet on ground, and extended torso, hip and knee to stand up, and in process of standing up, affected lower limb should fully bear weight; (vi) gait training: As patient’s standing‐balance and weight‐bearing ability of affected lower limb increased, patient could undertake ambulatory training between parallel bars or assisted gait training, after which progressing to unaided gait training; (vii) ADLs training" "Trunk control function training: (I) Training method while in lying position: (i). Therapist placed both hands on both sides of patient’s hypochondrium, and in line with breathing motion, pushed down and centrally on thorax; (ii). Therapist placed palm on patient’s abdomen, and in line with breathing motion, pushed up and inwards; (iii). With arms folded, independently extend the left and right shoulder forward, to train the twisting of upper trunk, and then with bent knees, keeping knees together, rotated pelvis to the right and left; (iv). Both legs or single‐leg bridging exercise. (II) Training method while in sitting position: (i). Keeping both knees and hip bent and kept together, arms crossed to embrace knees, and moving forwards and backward; (ii). While sitting on edge of bed, patient supported knee with both hands, therapist used both hands to control patient’s trunk to perform forward and backward pelvis motion, followed by extension and flexion of trunk on affected side via active assistive ranging exercise; (iii). While sitting on stool, with both hands propped on stool, trunk was twisted towards non‐affected side and twisted towards affected side, followed by training in shifting of body weight towards non‐affected side of the trunk; (iv). While sitting on side of bed, keeping knees and hip bent, both lower limbs lifted off the ground, to train trunk‐balance. (III) Training method while in standing position: (i). Patient placed both hands on treatment table while in standing position, therapist used one hand to lightly push patients' buttocks, while other hand controlled trunk, to train torso extension; (ii). Therapist placed one hand on patient’s buttocks, one hand on the abdomen, to train forwards and backwards motion of the pelvis; (iii). With both hands holding exercise bar, twisting and extension exercises were performed" 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 (passive) and neurophysiological intervention Length of intervention period: 23.8 ± 6.7 days of treatment on average for this group Number of sessions and length of individual sessions: once a day, each time 45 minutes, every week six times Intervention provider: not stated (2) Control group (n = 48) Control group received conventional rehabilitation as described above 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 (passive) Length of intervention period: 24.6 ± 6.5 days of treatment on average for this group Number of sessions and length of individual sessions: once a day, each time 45 minutes, every week six times Intervention provider: not stated This study is classified as active intervention one (functional task training, musculoskeletal (passive), neurophysiological) versus active intervention two (functional task training, musculoskeletal (passive)) (Table 9) |
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Outcomes | Measures of motor function: Fugl‐Meyer (balance ability and motor function of lower extremity) Other secondary outcome measures: Sheikh (truncal control) Time points when outcomes were assessed: before and after intervention |
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Notes | Original study translated from Chinese to English Note: Treatment group has been classified as neurophysiological based on the description of handling techniques provided in the paper. No reference is made to Bobath or Davies. The categorisation will be explored in a sensitivity analysis |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | No information provided |
Allocation concealment (selection bias) | Unclear risk | No information provided |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | No information provided |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | No dropouts described |
Free of systematic differences in baseline characteristics of groups compared? | Low risk | No significant baseline differences |
Did authors adjust for baseline differences in their analyses? | Low risk | No information provided |
Other bias | Unclear risk | No information provided |