Circuit-Based Rehabilitation Improves Gait Endurance but Not Usual Walking Activity in Chronic Stroke: A Randomized Controlled Trial

Mudge, Suzie; Barber, P. Alan; Stott, N. Susan

doi:10.1016/j.apmr.2009.07.015

Cited by 131 publications

(209 citation statements)

References 55 publications

(53 reference statements)

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“…Most studies report similar findings with gains in the ability to walk further and/or faster in the indoor clinic setting (10,(12)(13)(14). The size of the treatment effect in these studies is modest (e.g.…”

Section: Introductionsupporting

confidence: 50%

“…Several randomised controlled trials have investigated the use of exercise-based interventions to improve walking for people with stroke (10)(11)(12)(13)(14). Most studies report similar findings with gains in the ability to walk further and/or faster in the indoor clinic setting (10,(12)(13)(14).…”

Section: Introductionmentioning

confidence: 54%

“…The size of the treatment effect in these studies is modest (e.g. 20-50m increase in the six-minute walk test-a measure of walking capacity) and gains in walking ability following exercise are seldom sustained once the intervention has ceased (15,16,10,12). Further, it is unclear if gains in walking ability as measured in a clinic setting extend to changes in a real world setting (12,14).…”

Section: Introductionmentioning

confidence: 98%

“…A random effects analysis was undertaken (26). Two of the studies (11,12) used the same outcome measure (StepWatch Activity monitor) so an additional analysis for these studies using a mean difference could be completed. Three studies (12,14,30) did a follow-up assessment at 3 months post intervention and two studies (29,31) at 6 months and so follow-up results could be included for five studies.…”

Section: Data Extraction and Analysismentioning

confidence: 99%

“…20-50m increase in the six-minute walk test-a measure of walking capacity) and gains in walking ability following exercise are seldom sustained once the intervention has ceased (15,16,10,12). Further, it is unclear if gains in walking ability as measured in a clinic setting extend to changes in a real world setting (12,14). Behaviour change techniques such as goal setting, action planning and self-monitoring can be very effective at improving physical activity for healthy people (17), are familiar to rehabilitation professionals (18) and may a help sustain gains once professionally-led exercise programs finish.…”

Section: Introductionmentioning

confidence: 99%

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Can We Improve Real World Walking After Stroke? A Systematic Review and Meta-Analysis

Stretton

Mudge²,

McPherson³

et al. 2014

Archives of Physical Medicine and Rehabilitation

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Abstract:Objective: This study aimed to determine effectiveness of current interventions to improve real world walking for people with stroke and specifically whether benefits are sustained. Data sources: EBSCO Megafile, AMED, Cochrane, Scopus, PEDRO, OTSeeker and Psychbite databases were searched to identify relevant studies. Review methods: Proximity searching with key words such as ambulat*, walk*, gait, mobility*, activit* was used. Randomised controlled trials that used measures of real world walking were included. Two reviewers independently assessed methodological quality using the Cochrane Risk of Bias Tool and extracted the data. Results: Nine studies fitting the inclusion criteria were identified, most of high quality. A positive effect overall was found indicating a small effect of interventions on real world walking (SMD 0.29 [0.17, 0.41]). Five studies provided follow-up data at > 3-6 months which demonstrated sustained benefits (SMD 0.32 [0.16, 0.48]). Sub group analysis revealed studies using exercise alone were not effective 0.49]) but those incorporating behavioural change techniques (SMD 0.27 [0.12, 0.41]) were. Conclusions:A small but significant effect was found for current interventions and benefits can be sustained. Interventions which include behaviour change techniques appear more effective at improving real world walking habits than exercise alone.

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Section: Introductionsupporting

confidence: 50%

Section: Introductionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 98%

Section: Data Extraction and Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Can We Improve Real World Walking After Stroke? A Systematic Review and Meta-Analysis

Stretton

Mudge²,

McPherson³

et al. 2014

Archives of Physical Medicine and Rehabilitation

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Physical rehabilitation approaches for the recovery of function and mobility following stroke

Pollock

Baer

Campbell

et al. 2014

Cochrane Database of Systematic Reviews

375

311

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BackgroundVarious approaches to physical rehabilitation may be used after stroke, and considerable controversy and debate surround the effectiveness of relative approaches. Some physiotherapists base their treatments on a single approach; others use a mixture of components from several different approaches. ObjectivesTo determine whether physical rehabilitation approaches are effective in recovery of function and mobility in people with stroke, and to assess if any one physical rehabilitation approach is more effective than any other approach.For the previous versions of this review, the objective was to explore the effect of 'physiotherapy treatment approaches' based on historical classifications of orthopaedic, neurophysiological or motor learning principles, or on a mixture of these treatment principles. For this update of the review, the objective was to explore the effects of approaches that incorporate individual treatment components, categorised as functional task training, musculoskeletal intervention (active), musculoskeletal intervention (passive), neurophysiological intervention, cardiopulmonary intervention, assistive device or modality.In addition, we sought to explore the impact of time after stroke, geographical location of the study, dose of the intervention, provider of the intervention and treatment components included within an intervention.

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Physical fitness training for stroke patients

Brazzelli

Saunders²,

Greig³

et al. 2011

Cochrane Database of Systematic Reviews

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Circuit-Based Rehabilitation Improves Gait Endurance but Not Usual Walking Activity in Chronic Stroke: A Randomized Controlled Trial

Cited by 131 publications

References 55 publications

Can We Improve Real World Walking After Stroke? A Systematic Review and Meta-Analysis

Can We Improve Real World Walking After Stroke? A Systematic Review and Meta-Analysis

Physical rehabilitation approaches for the recovery of function and mobility following stroke

Physical fitness training for stroke patients

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