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. 2017 May 10;2017(5):CD006185. doi: 10.1002/14651858.CD006185.pub4

Westlake 2009.

Methods RCT
 Method of randomisation: computer‐generated random order (stratified by fast or slow walking)
 Blinding of outcome assessors: not described
 Adverse events: 1 in control group
 Deaths: none
 Dropouts: none
 ITT: yes
Participants Country: USA
 16 participants (8 in treatment group, 8 in control group)
 All were ambulatory at study onset
 Mean age: 57 years
 Inclusion criteria: hemiparesis resulting from a single cortical or subcortical stroke > 6 months before the study, categorised as at least unlimited household ambulatory, written informed consent
 Exclusion criteria: unstable cardiovascular, orthopaedic, or neurological conditions; uncontrolled diabetes that would preclude exercise of moderate intensity; significant cognitive impairment affecting ability to follow directions
Interventions 2 arms:
  • 12 physiotherapy sessions including gait training using the Lokomat (3 times a week over 4 weeks)

  • 12 physiotherapy sessions including manual guided gait training (3 times a week over 4 weeks)

Outcomes Outcomes were recorded at baseline and after 4 weeks
  • Self selected and fast walking speed

  • 6‐minute walk test

  • Absolute step length ratio

  • Lower extremity Fugl‐Meyer

  • Short Physical Performance Battery

  • Berg Balance Scale

  • Late‐Life Function & Disability Instrument

Notes
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Unclear
Allocation concealment (selection bias) Low risk Randomisation list was overseen by 1 of the investigators who had no contact with participants until group assignment was revealed.
 Group assignment was not revealed to study personnel until the participant consented and baseline testing was complete.
Blinding of outcome assessment (detection bias) 
 All outcomes High risk No
Incomplete outcome data (attrition bias) 
 All outcomes Low risk No missing data

ABC: Activities‐specific Balance Confidence
 ADL: activities of daily living
 CT: computed tomography
 FAC: Functional Ambulation Category
 ITT: intention‐to‐treat
 MMSE: Mini–Mental State Examination
 MRC: Medical Research Council
 MRI: magnetic resonance imaging
 NIHSS: National Institutes of Health Stroke Scale
 NYHA: New York Heart Association
 PF‐DF: plantar flexion and dorsiflexion
 RAGT: robot‐assisted gait training
 RCT: randomised controlled trial
 SF‐36: 36‐Item Short Form Health Survey