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Clin Rehabil. 2008 Mar;22(3):215-25. doi: 10.1177/0269215507081922.

How feasible is the attainment of community ambulation after stroke? A pilot randomized controlled trial to evaluate community-based physiotherapy in subacute stroke.

Author information

1
Department of Medicine (Rehabilitation), Wellington School of Medicine and Health Sciences, University of Otago, Wellington Sth 6002, New Zealand. sue.lord@ts.co.nz

Abstract

OBJECTIVE:

This pilot randomized controlled trial evaluated an assistant-led, community-based intervention to improve community mobility and participation after stroke, and examined the potential for independent community ambulation in people with subacute stroke who present with moderate gait deficit.

DESIGN:

A multicentre, pilot randomized controlled trial.

SETTING:

Three hospitals and three community settings in New Zealand.

SUBJECTS:

Thirty post-acute, home-dwelling stroke survivors were randomly allocated to receive intervention in the community (n = 14) or as hospital outpatients (n = 16) twice a week for seven weeks.

INTERVENTIONS:

The community intervention involved practice of functional gait activities in community environments relevant to each participant. Hospital-based physiotherapy was based upon a Motor Relearning approach.

MAIN MEASURES:

The primary outcome measure was gait speed (m/min). Secondary outcomes included endurance (six-minute walk time), Activities-specific Confidence Balance Scale, and the Subjective Index of Physical and Social Outcomes measured at baseline, post intervention and six months.

RESULTS:

Large gains in gait speed were obtained for participants in both groups: community group mean (SD) 16 (16.1) m/min; physiotherapy group mean (SD) 15.9 (16.1) m/min, maintained at six months. There were no significant differences between groups for primary and secondary outcomes after treatment (P = 0.86 ANOVA) or at six months (P = 0.83 ANOVA). Only 11 participants reported independent community ambulation. Levels of social integration were low to moderate.

CONCLUSIONS:

A community-based gait recovery programme appears a practicable alternative to routine physiotherapy, however independent community ambulation is a challenging rehabilitation goal.

PMID:
18285431
DOI:
10.1177/0269215507081922
[Indexed for MEDLINE]
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