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Volume 44 Number 5 2007
Pages 637 — 648


Abstract - Effects of intensive gait-oriented physiotherapy during early acute phase of stroke

Sinikka H. Peurala, PhD;1-2* Olavi Airaksinen, MD, PhD;3 Pekka Jäkälä, MD, PhD;1 Ina M. Tarkka, PhD;4 Juhani Sivenius, MD, PhD1,4

1Department of Neurology, Kuopio University Hospital, Kuopio, Finland; 2Department of Health Sciences, The Finnish Centre for Interdisciplinary Gerontology, University of Jyväskylä, Jyväskylä, Finland; 3Department of Physical Medicine and Rehabilitation, Kuopio University Hospital, Kuopio, Finland; 4Brain Research and Rehabilitation Center Neuron, Kuopio, Finland

Abstract — We assessed the effects and strenuousness of intensive gait-oriented inpatient rehabilitation initiated very early after stroke. Therapy content and interrater reliability of the assessments were also analyzed. Of 22 patients, 19 (average 8.0 d poststroke) completed the study. Before rehabilitation, 13 patients were unable to walk or needed two assistants to walk and 6 patients needed one assistant. Patients spent a daily maximum of 1 h therapy time to obtain 20 min of walking. Additional physiotherapy was also provided during the 3 wk therapy period. Seven structured motor tests were recorded before and after rehabilitation and at 6 months postrehabilitation, and perceived exertion was followed during physiotherapy. After rehabilitation, 16 patients could walk unassisted and 3 needed one assistant to walk. Mean +/- standard deviation exercise walking distance was 10,784 +/- 4,446 m and exercise was ranked as slightly strenuous. After 3 wk, the patients' 10 m walking time, ankle spasticity, lower-limb muscle force, and motor scale scores improved (p < 0.05). The early intensive rehabilitation was well tolerated and only three patients dropped out. Improved motor abilities were seen in all stroke patients.

Clinical Trial Registration: ClinicalTrials.gov; Gait Trainer vs Traditional Physiotherapy in Acute Stroke, NCT00307762; <http://clinicaltrials.gov/ct/show/NCT00307762>.

Key words: acute, body-weight supported gait, cerebral infarction, exercise therapy, neurorehabilitation, physiotherapy, rehabilitation, stroke, task-specific therapy, walking.


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