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Can augmented physiotherapy input enhance recovery of mobility after stroke ?
WELLWOOD I
CLIN REHABIL , 2004, vol. 18, n° 5, p. 529-537 Doc n°: 114842 Localisation : Documentation IRR Descripteurs : AF21 - ACCIDENTS VASCULAIRES CEREBRAUX, KA91 - PHYSIOTHERAPIE Objective: To discover if the provision of additional inpatient physiotherapy after stroke speeds the recovery of mobility. Design: A multisite single-blind randomized controlled trial (RCT) comparing the effects of augmented physiotherapy input with normal input on the recovery of mobility after stroke. Setting: Three rehabilitation hospitals in North Glasgow, Scotland. Subjects: Patients admitted to hospital with a clinical diagnosis of stroke, who were able to tolerate and benefit from mobility rehabilitation. Intervention: We aimed to provide double the amount of physiotherapy to the augmented group. Main measures: Primary outcomes were mobility milestones (ability to stand, step and walk), Rivermead Mobility Index (RMI) and walking speed. Results: Seventy patients were recruited. The augmented therapy group received more direct contact with a physiotherapist (62 versus 35 minutes per weekday) and were more active (8.0% versus 4.8% time standing or walking) than normal therapy controls. The augmented group tended to achieve independent walking earlier (hazard ratio 1.48, 95% confidence interval 0.90-2.43; p=0.12) and had higher Rivermead Mobility Index scores at three months (mean difference 1.6; -0.1 to 3.3; p=0.068) but these differences did not reach statistical significance. There was no significant difference in any other outcome. Conclusions: A modest augmented physiotherapy programme resulted in patients having more direct physiotherapy time and being more active. The inability Langue : ANGLAIS |
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