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. 2006 Apr 19;2006(2):CD003241. doi: 10.1002/14651858.CD003241.pub2

Bogataj 1995.

Methods Design: A randomised crossover trial (in this review we only extracted data from baseline to crossover point). Randomisation: 'randomly assigned'. 
 Dropouts: None reported.
Participants 20 inpatients recruited, all were right‐side dominant. 
 Experimental: 5 male & 5 female, 2 left hemiplegia & 8 right hemiplegia, mean age 53.4 years (SD 11.5), mean time after stroke 116 days (SD 66). 
 Control: 6 male & 4 female, 9 left hemiplegia & 1 right hemiplegia, mean age 59.1 years (SD 9), time after stroke 104 days (SD 62). 
 Study criteria: (1) could stand independently or with aid of one or two therapists; (2) muscle contraction with indicated movement in the corresponding joint obtained by functional electrical stimulation for each muscle treated; (3) exertion during therapy would not adversely affect participant's health; (4) preserved perceptual and intellectual abilities; (5) no suspected or confirmed cardiovascular infarction or demand pacemaker; (6) no extreme reflex activity; (7) no hypersensitivity; (8) no pain; (9) no lower motor neurone lesion; (10) no changes to skin in area of stimulation; (11) no changes in bone‐joint structures; (12) agreed to application of functional electrical stimulation.
Interventions Duration: 3 weeks 
 Experimental: 
 Category = 5. 
 Multichannel functional electrical stimulation therapy given for 30 to 60 minutes per session (including application of electrodes), once a day, 5 times a week for 3 weeks. Amplitudes of the stimulating pulses set to 80% of amplitude which produced non‐volitional movement in joint. Stimulation sequence was determined for each participant so that optimum correction of anomalies was achieved. During stimulation gait could be facilitated by a therapist and a crutch could be used. Electrodes were applied to peroneal nerve, soleus, hamstrings, quadriceps femoris group, gluteus maximus and, optionally, to triceps brachii. 
 Control: Conventional gait therapy consisting of a 'passive and active approach'. The emphasis was on the active approach which consisted of Bobath techniques, PNF, visual biofeedback, audiovisual biofeedback, gait training and use of orthoses. The passive approach included icing, heating, brushing, positioning and use of a tilt table. Therapy was provided once a day, 5 times a week for 3 weeks. 
 Comparison: Electrostimulation vs conventional.
Outcomes Baseline measurement: beginning of therapy period. 
 Outcome measurement: End of therapy period i.e. 3 weeks. 
 Included outcomes: (1) stride length; (2) gait velocity; (3) cadence; (4) Fugl‐Meyer Assessment. 
 Other outcomes: (1) vertical ground reaction force during stance phase; (2) trajectory of centre of pressure under each foot in stance phase.
Notes The type of electrode used was changed at some point during the study and this may be a confounding factor.
Excluded patients who refused application of functional electrical stimulation.
Some weight shifting was facilitated by a therapist accompanying experimental participants walking with electrostimulation applied. This replicates some of the conventional therapy provided to the control group but it appears that this was minimal. However, this could be a confounding factor affecting interpretation of the results of this trial.
Some missing data in experimental group.
Risk of bias
Bias Authors' judgement Support for judgement
Allocation concealment? High risk C ‐ Inadequate