Virtual Reality- lower extremity
Introduction
NOTE: This module focuses on virtual reality for the lower extremity. For the upper extremity please click here.
Virtual Reality (VR) is an environment that is simulated by a computer. It provides an interactive multi-sensory stimulation in real-time. VR provides users with the opportunity to engage in activities within an environment that appears and feels similar to real world objects and events. Users can interact with a virtual environment through the use of standard input devices such as a keyboard and mouse, or through multimodal devices such as a wired glove.
VR is becoming increasingly popular as it can be easily modified according to the needs of individuals, it is perceived as being fun and motivating for patients, and it allows researchers to incorporate elements such as feedback that have been shown to maximize motor learning. On the negative side, there is concern that the use of VR in the clinic is not possible due to the cost of the required equipment. While certainly true when this technology was created, the cost of virtual reality hardware and software has decreased and is now reasonably affordable for clinical use.
NOTE: In this module we did not differentiate between immersive and non-immersive VR. This categorization is determined mainly by the degree of ‘virtual presence’ the subject experienced during training, and this information was not made readily available in most of the studies reviewed.
NOTE: This review focuses on any type of therapy involving a virtual environment. For a specific review of commercial game systems used for physical rehabilitation (e.g. Sony Playstation EyeToy, Nintendo Wii), please see the Video Games module (to date, only the upper extremity has been reviewed).
To date 6 high quality RCTs, 3 fair quality RCTs, 1 quasi-experimental and 2 single-subject design pre-post studies have investigated the effect of virtual reality for the lower extremity on rehabilitation in patients with stroke.
Authors*: Adam Kagan BSc, Dr. Nicol Korner-Bitensky PhD OT
Expert reviewer: Francine Malouin PhD, PT
NOTE: *The authors and expert reviewers have no direct financial interest in any tools, tests or interventions presented in Stroke Engine.
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
A randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
*high quality = PEDro score 6-10
*fair quality = PEDro score 4-5
*poor quality = PEDro score ≤ 3
The PEDro scale was developed by the Physiotherapy Evidence Database to determine the quality of clinical trials. The PEDro scale consists of a checklist of 10 scored yes-or-no questions pertaining to the internal validity and the statistical information provided. Please click on the link for more information: http://www.pedro.org.au/english/downloads/pedro-scale/
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
Patients longer than 6 months post-stroke are identified as in chronic stage of recovery.
| 1a (Strong) | Well-designed meta-analysis, or 2 or more high quality RCTs (PEDro ≥ 6) showing similar findings |
| 1b(Moderate) | 1 RCT of high quality (PEDro ≥ 6) |
| 2a (Limited) | At least 1 fair quality RCT (PEDro = 4-5) |
| 2b (Limited) | At least one poor quality RCT (PEDro < 4) or well-designed non-experimental study (non-randomized controlled trial, quasi-experimental studies, cohort studies with multiple baselines, single subject series with multiple baselines, etc.) |
| 3(Consensus) | Agreement by an expert panel or a group of professionals in the field or a number of pre-post studies all with similar results |
| 4 (Conflicting) | Conflicting evidence of 2 or more equally well-designed studies |
| 5 (No evidence) | No well-designed studies - only case studies/case descriptions or cohort studies/single subject series with no multiple baselines) |