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Physiotherapy intervention late after stroke and mobility.

D T Wade1, F M Collen, G F Robb

  • 1Rivermead Rehabilitation Centre, Oxford.

BMJ (Clinical Research Ed.)
|March 7, 1992
PubMed
Summary
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Physiotherapist intervention improved mobility in stroke survivors over one year post-stroke, particularly gait speed. However, these mobility gains were not sustained, suggesting a need for ongoing support.

Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Gerontology

Background:

  • Stroke is a leading cause of long-term disability, often resulting in reduced mobility.
  • Mobility deficits persist more than one year after stroke, impacting daily living.
  • The potential for rehabilitation interventions to improve outcomes in chronic stroke is an area of ongoing research.

Purpose of the Study:

  • To evaluate the effectiveness of physiotherapy intervention in improving mobility in patients over one year post-stroke.
  • To assess changes in gait speed and other functional measures following physiotherapy.
  • To determine if physiotherapy offers sustained benefits for chronic stroke survivors.

Main Methods:

  • A randomized crossover trial was conducted with patients experiencing reduced mobility over one year post-stroke.

Related Experiment Videos

  • Two groups received physiotherapy intervention: one immediately and the other after a three-month delay.
  • Mobility was assessed using standard measures including gait speed, functional ambulation, and activities of daily living indices.

    • Main Results:

    • The group receiving immediate physiotherapy showed improved gait speed compared to the delayed group, which declined.
    • Between three and six months, the delayed group improved, while the previously treated group declined.
    • A 9% decrease in 10-meter walk time was associated with physiotherapy, but effects were not maintained.

    Conclusions:

    • Physiotherapist intervention can specifically improve mobility in chronic stroke patients, though the effect size is modest.
    • Gait speed is a sensitive and simple measure for assessing outcomes in this population.
    • The lack of sustained improvement suggests an underlying decline in mobility that may require continuous management.