Can augmented physiotherapy input enhance recovery of mobility after stroke? A randomized controlled trial.
OBJECTIVE
To discover if the provision of additional inpatient physiotherapy after stroke speeds the recovery of mobility.


METHODS
A multisite single-blind randomized controlled trial (RCT) comparing the effects of augmented physiotherapy input with normal input on the recovery of mobility after stroke.


METHODS
Three rehabilitation hospitals in North Glasgow, Scotland.


METHODS
Patients admitted to hospital with a clinical diagnosis of stroke, who were able to tolerate and benefit from mobility rehabilitation.


METHODS
We aimed to provide double the amount of physiotherapy to the augmented group.


METHODS
Primary outcomes were mobility milestones (ability to stand, step and walk), Rivermead Mobility Index (RMI) and walking speed.


RESULTS
Seventy patients were recruited. The augmented therapy group received more direct contact with a physiotherapist (62 versus 35 minutes per weekday) and were more active (8.0% versus 4.8% time standing or walking) than normal therapy controls. The augmented group tended to achieve independent walking earlier (hazard ratio 1.48, 95% confidence interval 0.90-2.43; p=0.12) and had higher Rivermead Mobility Index scores at three months (mean difference 1.6; -0.1 to 3.3; p=0.068) but these differences did not reach statistical significance. There was no significant difference in any other outcome.


CONCLUSIONS
A modest augmented physiotherapy programme resulted in patients having more direct physiotherapy time and being more active. The inability to show statistically significant changes in outcome measures could indicate either that this intervention is ineffective or that our study could not detect modest changes.
Academic Section of Geriatric Medicine, Royal Infirmary, Glasgow, UK.
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D026741:Physical Therapy Modalities; D015397:Program Evaluation; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016138:Walking / Q000502:physiology