Effects of intensive gait-oriented physiotherapy during early acute phase of stroke

Abstract

Abstract-We assessed the effects and strenuousness of intensive gait-oriented inpatient rehabilitation initiated very early after stroke. Therapy content and interrater reliability of the assessments were also analyzed. Of 22 patients, 19 (average 8.0 d poststroke) completed the study. Before rehabilitation, 13 patients were unable to walk or needed two assistants to walk and 6 patients needed one assistant. Patients spent a daily maximum of 1 h therapy time to obtain 20 min of walking. Additional physiotherapy was also provided during the 3 wk therapy period. Seven structured motor tests were recorded before and after rehabilitation and at 6 months postrehabilitation, and perceived exertion was followed during physiotherapy. After rehabilitation, 16 patients could walk unassisted and 3 needed one assistant to walk. Mean +/-standard deviation exercise walking distance was 10,784 +/-4,446 m and exercise was ranked as slightly strenuous. After 3 wk, the patients' 10 m walking time, ankle spasticity, lower-limb muscle force, and motor scale scores improved (p < 0.05). The early intensive rehabilitation was well tolerated and only three patients dropped out. Improved motor abilities were seen in all stroke patients.Clinical Trial Registration: ClinicalTrials.gov; Gait Trainer vs Traditional Physiotherapy in Acute Stroke, NCT00307762; <http://clinicaltrials.gov/ct/show/NCT00307762>.

How Physically Active Are People with Stroke in Physiotherapy Sessions Aimed at Improving Motor Function? A Systematic Review

“…All of the included studies were assessed as having a low risk of bias except Peurala et al [14] which was assessed as having moderate to high risk of bias (Table 2). In Peurala et al [14], there were no independent observers involved (the same therapists that provided the therapy also evaluated content and duration), the data collection methods were not adequately described, and the data collection instrument was not validated.…”

Longitudinal study on modulated corticospinal excitability throughout recovery in supratentorial stroke

“…2) functional ambulatory category (FAC) 0-3 [12,21] 3) remaining ability to move the leg of the affected side 4) BI 25-75 points 5) body mass index < 32…”

“…Patients received a three-week period of intensive inpatient gait-oriented rehabilitation in the acute care hospital [21]. The local research ethics committee approved the study (2/2005).…”

Early upper limb physiotherapy in stroke patients. Questions without answers

“…Natomiast czas aktywnej terapii ruchowej KG chorych średnio 5,6 dnia od udaru wynosił ok. 4 minuty w jednej sesji (17% całej jednostki terapeutycznej) i ok. 11 minut w sesji terapii zajęciowej (49% całej jednostki terapeutycznej) [23]. W fińskim badaniu Peurala et al wykazał, że dawka czasowa aktywności KG chorych (n=19) (średnio osiem dni od udaru) podczas fizjoterapii stanowi ok. 6 minut ćwiczeń na sesję (15% jednostki terapeutycznej) [24,25]. Australijskie doniesienia (n=32) dotyczące chorych (średnio 40 dni od udaru) mówią o braku aktywności KG podczas fizjoterapii [26].…”

“…11 minutes during an occupational therapy session (49% of the whole therapeutic session) [23]. In the Finnish study by Peurala et al, it was noted that on average 8 days post stroke, patients (n=19) received 6 minutes of UL training per session (15% of a therapeutic session) [24,25]. Australian reports (n=32) concerning patients (an average of 40 days post stroke) revealed the lack of UL activity during physiotherapy [26].…”