Randomised controlled trials (RCTs) of patients who had suffered a stroke at least six months previously, where standard practice active physiotherapy interventions (defined in the paper) were compared with control or placebo treatment, were eligible for inclusion. Trials had to enroll at least five patients in each treatment group. Trials in which active treatment focussed on the upper extremities were excluded, as were trials that used techniques that were highly innovative or poorly used in most community-based rehabilitation services.
The primary outcomes were mobility and independence with activities of daily living, measured with previously validated tools.
The mean age of included patients was 70.3 years; 59% were men. The proportion of the body side affected was comparable between treatment groups. There was wide variation in baseline functional activity of the patients. Treatments included neuromuscular interventions, the practice of functional activities, muscle strengthening, and application of assistive equipment. The comparators were no treatment (where reported) and the use of a passive range of motion activities (such as the usual activities of daily living, sham home exercise programmes, social and educational sessions, and seated upper extremity exercises). The interventions were delivered at home, in out-patient clinics, and mixed outpatient and home settings. The duration of single treatments ranged from 10 minutes and two hours; the duration of the interventions ranged from four to 26 weeks. Most trials varied in terms of duration and type of off-protocol treatments. The outcomes reported were mobility as measured by short-distance walking (time to cover 10 metres), long-distance walking (distance achieved in six-minutes of walking), and attainment of independence with activities of daily living.
Two reviewers performed the study selection: any disagreements were resolved by consensus.