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The effects of lower extremity cross-training on gait and balance in stroke patients: a double-blinded randomised controlled trial [with consumer summary]
Park C, Son H, Yeo B
European Journal of Physical and Rehabilitation Medicine 2021 Feb;57(1):4-12
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Cross-training is an indirect intervention to promote muscle activity on the affected side by applying resistance exercise to stronger parts of the body. Indirect interventions are useful for treating patients who have difficulty with direct interventions. Previous studies have focused on measuring increased muscle strength and muscle activity in healthy individuals. AIM: This study aimed to investigate the effects of cross-training on gait and balance in hemiplegic patients when applied to the affected and unaffected lower extremities. DESIGN: Double-blinded randomised controlled trial. SETTING: In-patients attending the rehabilitation treatment room of a single centre. POPULATION: Fifty-two stroke patients were randomly allocated to a control group (n = 19), affected side cross-training group (n = 15), and unaffected side cross-training group (n = 18). METHODS: Patients were administered general neurological physiotherapy for 30 mins, twice daily, 5 days/week for 4 weeks. The two intervention groups underwent 30 mins of cross-training instead of general neurological physiotherapy once daily, 3 days/week for 4 weeks (post-intervention). For data analysis, one-way ANOVA for between-group comparisons and paired t-tests were performed for within-group comparisons between pre- and post-intervention groups (significance level of 0.05). RESULTS: In the Timed Up and Go test (TUG), comparing pre- and post-intervention, the control group showed no significant change (p > 0.05), while the affected side and unaffected side cross-training groups showed significant improvements in function (p < 0.05). In the 10 Meter Walk Test (10MWT), the control group showed no significant change (p > 0.05), while the affected side and unaffected side cross-training groups showed significant increases in speed (p < 0.05). In balance testing, the limits of stability showed a significantly increase in all three groups (p < 0.05). There were no pre- or post-intervention differences in gait or balance between the groups (p > 0.05). CONCLUSIONS: Gait and balance improved in hemiplegic stroke patients who participated in cross-training, regardless of the intervention applied to the affected or unaffected side.

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