Article

This study compared two modes of physiotherapy service over 12 months
in community-dwelling people with stroke, either following a train-wait train
paradigm by providing bouts of intense physiotherapy, or a continuous less
intense programme.
Community-dwelling people
with stroke. INTERVENTIONS: Fifty patients, first-time stroke, discharged home,
following inpatient rehabilitation, allocated to two groups, A and B. Over 12
months, Group A (n = 25) received three two-month blocks of therapy at home, each
block contained four 30 to 45 minute sessions per week, totalling 96 sessions.
Group B (n = 25) continuously received two 30 to 45 minute sessions per week,
totalling 104 sessions. MAIN OUTCOME MEASURES: Primary Rivermead Mobility Index
(0-15), secondary upper- and lower-limb motor functions, Activities of Daily
Living competence, tone and number of falls. RESULTS: Both groups were comparable
at onset, the mean age in Group A (B) was 62.4 (61.9) years. A and B patients
equally improved functions over time, between group differences did not occur.
The initial (terminal) Rivermead Mobility Index was 9.4 +/- 2.8 (12.2 +/- 2.1) in
Group A, and 8.5 +/- 3.5 (11.2 +/- 2.7) in Group B. More Group B patients fell
seriously (7 versus 1). CONCLUSIONS: The intermittent high-intensity and
continuous low-intensity therapy protocols were equally effective, the sheer
intensity seems more important than the time-mode of application. The relatively
young patients functionally improved in the first year after stroke, the reduced
risk of serious falls in the intermittent high-intensity group should be
validated.

Langue : ANGLAIS