Physiotherapy for patients with mobility problems more than 1 year after stroke: a randomised controlled trial

Area of Science:

• Neurology
• Rehabilitation Medicine
• Geriatric Medicine

Background:

• Community physiotherapy is a common intervention for stroke patients experiencing persistent mobility issues.
• This study investigates the efficacy of community physiotherapy in individuals with mobility deficits one year after stroke.

Purpose of the Study:

• To evaluate the effectiveness of community physiotherapy on long-term mobility problems in stroke patients.
• To assess the impact of community physiotherapy on various functional and psychological outcomes.

Main Methods:

• A single-masked, randomized controlled trial involving 170 patients over 50 years old, one year post-stroke.
• Primary outcome: Rivermead Mobility Index. Secondary outcomes: gait speed, falls, Barthel Index, Frenchay Activities Index, anxiety, depression, and carer stress.
• Intention-to-treat analysis with assessments at baseline, 3, 6, and 9 months.

Main Results:

• A statistically significant, but clinically minor, improvement in Rivermead Mobility Index scores (median 1 point) was observed at 3 months.
• Gait speed increased by 2.6 m/min at 3 months in the physiotherapy group.
• These improvements were not sustained at 6 or 9 months, with no significant effects on daily activity, social activity, falls, or psychological well-being.

Conclusions:

• Community physiotherapy provides temporary, modest improvements in mobility and gait speed for stroke patients with long-term mobility issues.
• The benefits of community physiotherapy are not sustained beyond the treatment period, suggesting limited long-term impact.