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Dosis-wirkungs-beziehungen bei der rehabilitation der mobilitut nach schlaganfall erkenntnisse aus der s2e-leitlinie (ReMoS) (Dose-response relationship for rehabilitation of mobility after stroke) [German]
Tholen R, Saal S, Wittenberg H, Quintern J, Stephan KM, Dohle CH
Neurologie und Rehabilitation 2017 Apr;23(1):39-44
systematic review

The aim of this article is to summarize the evidence of a dose-response relationship on mobility (gait, gait-related activities) in patients after stroke. The results have already been discussed in the chapter 'Organisation der Therapieeinheiten' (organization of therapy) in the ReMoS-guideline and were supplemented with an update of the current evidence. Methodologically, the work is based on an original systematic literature search of the ReMoS-guideline for post-stroke rehabilitation of the lower extremities (2012), which focused on walking ability, gait speed, walking distance and balance. In addition, the search was updated with regard to dose-response relationships. Nine randomized controlled trials (RCT) which focused on the doseresponse relationship were included from the research of 2012. In addition, two systematic reviews from the 2016 update were included in the evaluation. Based on these results, the ReMoS-guideline recommends a significantly higher usage of specific leg training or walking training for subacute patients to increase walking ability (at least 30 min/day), walking speed (at least 30 min/day) and walking distance (more than 60 min/week). For chronic patients, 60 min/week of additional walking training potentially increases walking speed and distance. However, specific leg or walking exercises are required to improve walking. Unspecific functional exercises do not lead to comparable results. Those who wish to improve their walking ability need to practice walking.

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