PTOtherJournal of physical therapy science2017

Short-term effects of physiotherapy combining repetitive facilitation exercises and orthotic treatment in chronic post-stroke patients.

Kazutoshi Tomioka, Shuji Matsumoto, Keiko Ikeda and 5 others

PMID 28265141

WHAT IT FOUND

Four weeks of repetitive facilitation exercises plus AFO gait training were followed by better lower-limb and walking scores in 27 chronic stroke patients.

Both treatments were given together, so neither can be credited alone.

Key findings

01After 4 weeks, lower-limb motor scores improved: FMA-LE rose from 22.96 to 25.85, and SIAS rose from 46.59 to 53.63, with p<0.01.

02Walking measures improved: TUG fell from 17.35 to 14.02 seconds, comfortable gait speed rose from 0.68 to 0.81 m/sec, and fast gait speed rose from 0.80 to 0.96 m/sec, with p<0.01.

03Because RFE and AFO gait training were given together and there was no control group, the study cannot show which component caused the changes.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

There was no control group and no randomisation, so the study cannot compare the combination with another treatment. RFE and AFO gait training were given together, so the contribution of either component cannot be separated. The study had only 27 participants, and the authors say the small number and 4-week period limit generalisation. The same staff implemented assessment and training, so observer bias and subject bias could not be excluded. Participants had to be able to walk with a T-cane and/or AFO, and the paper does not report a separate analysed number.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not conclude that repetitive facilitation exercises or the AFO alone caused the improvements. All participants received both together, and there was no control group, so the study cannot separate their effects.

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