Task-Oriented Training – Lower Extremity / Mobility

Two high quality RCTs (Richards et al., 1993; Langhammer & Stanghelle, 2000) and one quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
(Rose et al., 2011) investigated the effect of lower extremity task-oriented training on balance in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The high quality RCTA 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. (Richards et al., 1993) randomized patients to receive (i) early, intensive gait-focused task-oriented physical therapy, (ii) early, high-intensity conventional rehabilitation, or (iii) conventional rehabilitation. Balance was measured by the Berg Balance Scale and Fugl Meyer Assessment (balance subscaleMany measurement instruments are multidimensional and are designed to measure more than one construct or more than one domain of a single construct. In such instances subscales can be constructed in which the various items from a scale are grouped into subscales. Although a subscale could consist of a single item, in most cases subscales consist of multiple individual items that have been combined into a composite score (National Multiple Sclerosis Society).
) at post-treatment (6 weeks) and at follow-up (3 and 6 months post-stroke). No significant between-group differences were found on either balance measure at any time points.

The second high quality RCTA 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. (Langhammer & Stanghelle, 2000) randomized patients to receive lower extremity task-oriented training using a Motor Relearning Programme or Bobath-based treatment for the duration of hospitalization. Balance was measured by the Sødring Motor Evaluation Scale (balance/trunk control score) at 2 weeks and at 3 months post-stroke. No significant between-group difference was found at any time point.

The quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
(Rose et al., 2011) assigned patients to receive lower extremity task-oriented mobility training or conventional rehabilitation. Balance was measured by the Berg Balance Scale at post-treatment (discharge from hospital, average length of stay of 20 days). No significant between-group difference was found.

Conclusion: There is strong evidence (Level 1a) from two high quality RCTs and one quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
that lower extremity task-oriented training is not more effective than comparison interventions (conventional rehabilitation, Bobath-based treatment) for improving balance in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Three high quality RCTs (Richards et al., 1993; Langhammer & Stanghelle, 2000; van Vliet et al., 2005) and one quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
(Rose et al., 2011) investigated the effect of lower extremity task-oriented training on functional independence in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The high quality RCTA 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. (Richards et al., 1993) randomized patients to receive (i) early, intensive gait-focused task-oriented physical therapy, (ii) early, high-intensity conventional rehabilitation, or (iii) conventional rehabilitation. Functional independence was measured by the Barthel Index (BI) at post-treatment (6 weeks) and at follow-up (3 and 6 months post-stroke). No significant between-group differences were found at any time points.

The second high quality RCTA 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. (Langhammer & Stanghelle, 2000) randomized patients to receive lower extremity task-oriented training using a Motor Relearning Programme or Bobath-based treatment for the duration of hospitalization. Functional independence was measured by the BI (feeding, transferring from wheelchair to bed and back, personal hygiene, getting on and off toilet, bathing, walking on level surface/propelling wheelchair, ascending and descending stairs, dressing, controlling bowels, controlling bladder) at baseline and at 3 months post-stroke. On three measures of functional independence (BI toilet, bowel, bladder scores), there was a significant between-group difference at 3 months post-stroke, and a significant between-group difference in the change in score from baseline to 3 months, favoring task-oriented training vs. Bobath-based treatment. There were no significant differences on other BI subscores.

The third high quality RCTA 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. (van Vliet et al., 2005) randomized patients to receive lower extremity task-oriented training using a Motor Relearning Programme or Bobath-based treatment. Functional independence was measured by the BI at 1 month, 3 months and 6 months. There was a significant between-group difference in only one measure of functional independence (BI bathing score) at 1 month follow-up, favoring task-oriented training vs. Bobath-based treatment. There were no significant differences on other BI subscores at any time points.
Note: The treatment did not have a specific ‘end-point’ and continued as long as was needed.

The quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
(Rose et al., 2011) assigned patients to receive lower extremity task-oriented mobility training or conventional rehabilitation. Functional independence was measured by the Functional Independence Measure (FIM – phone version) at 90 days post-stroke. No significant between-group difference was found.

Conclusion: There is strong evidence (Level 1a) from three high quality RCTs and one quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
that lower extremity task-oriented training is not more effective than comparison interventions (conventional rehabilitation, Bobath-based treatment) in improving functional independence in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCTA 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. (Langhammer & Stanghelle, 2000) investigated the effect of lower extremity task-oriented training on gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA 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. randomized patients to receive task-oriented training using a Motor Relearning Programme or Bobath-based treatment for the duration of hospitalization. GaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
was measured by the Sødring Motor Evaluation Scale (gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
score) at 2 weeks and at 3 months post-stroke. No significant between-group difference was found at any time point.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA 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. that lower extremity task-oriented training is not more effective than a comparison intervention (Bobath-based treatment) in improving gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (Langhammer & Stanghelle, 2000) and one quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
(Rose et al., 2011) investigated the effect of lower extremity task-oriented training on health-related quality of life in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The high quality RCTA 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. (Langhammer & Stanghelle, 2000) randomized patients to receive lower extremity task-oriented training using a Motor Relearning Programme or Bobath-based treatment for the duration of hospitalization. Health-related quality of life was measured by the Nottingham Health Profile at 3 months post-stroke. No significant between-group difference was found.

The quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
(Rose et al., 2011) assigned patients to receive task-oriented mobility training or conventional rehabilitation. Health-related quality of life was measured by the StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. Impact Scale (SIS) at 90-days post-stroke. No significant between-group difference was found.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA 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. and one quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
that lower extremity task-oriented training is not more effective than comparison interventions (Bobath-based treatment, conventional rehabilitation) in improving health-related quality of life in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (van Vliet et al., 2005) investigated the effect of lower extremity task-oriented training on instrumental activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
of daily living (IADLs) in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to receive lower extremity task-oriented training using a Motor Relearning Programme or Bobath-based treatment. IADLs were measured by the 22-item Extended ActivitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
of Daily Living Scale (EADLS) at 1 month, 3 months and 6 months. There was a significant between-group difference on only one IADL item (EADLS – Leisure: go out socially) at all time point, in favor of task-oriented training vs. Bobath-based treatment.
Note: The treatment did not have a specific ‘end-point’ and continued as long as needed.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA 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. that lower extremity task-oriented training is not more effective than a comparison intervention (Bobath-based treatment) in improving IADLs in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Three high quality RCTs (Richards et al., 1993, Langhammer & Stanghelle, 2000; van Vliet et al., 2005) and one quasi-experimental study (Rose et al., 2011) investigated the effect of lower extremity task-oriented training on lower extremity motor function in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The first high quality RCTA 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. (Richards et al., 1993) randomized patients to receive (i) early, intensive gait-focused task-oriented physical therapy, (ii) early, high-intensity conventional rehabilitation, or (iii) conventional rehabilitation. Lower extremity motor function was measured by the Fugl-Meyer Assessment (FMA; lower extremity scale) at post-treatment (6 weeks) and at follow-up (3 and 6 months post-stroke). No significant between-group differences were found at any time points.

The second high quality RCTA 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. (Langhammer & Stanghelle, 2000) randomized patients to receive lower extremity task-oriented training using a Motor Relearning Programme or Bobath-based treatment. Lower extremity motor function was measured by the Sødring Motor Evaluation Scale (SMES; lower extremity, mobility scales) and the Motor Assessment Scale (MAS), at baseline, 2 weeks, and at 3 months post-stroke. No significant between-group differences were found on any measures, at either time point. There was no between-group difference in change from baseline to 2 weeks, or from baseline to 3 months post-stroke, measured using the MAS.

The third high quality RCTA 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. (van Vliet et al., 2005) randomized patients to receive lower extremity task-oriented training using a Motor Relearning Programme or Bobath-based treatment. Lower extremity motor function was measured by the Rivermead Motor Assessment and the MAS at 1 month, 3 months and 6 months. No significant between-group differences were found for either measure of lower extremity motor function at any time points.
Note: The treatment did not have a specific ‘end-point’ and continued as long as needed.

The quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
(Rose et al., 2011) assigned patients to receive task-oriented mobility training or conventional rehabilitation. Lower extremity motor function was measured by the FMA (lower extremity motor scale) at post-treatment (discharge from hospital, average length of stay of 20 days). No significant between-group difference was found.

Conclusion: There is strong evidence (Level 1a) from three high quality RCTs and one quasi experimental study that lower extremity task-oriented training program is not more effective than comparison interventions (conventional rehabilitation, Bobath-based treatment) for improving lower extremity motor function in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (an Vliet et al., 2005v) investigated the effect of lower extremity task-oriented training on lower extremity spasticityInvoluntary muscle tightness and stiffness that can occur after a stroke. It is characterized by exaggerated deep tendon reflexes that interfere with muscular activity, gait, movement, or speech. Spasticity can increase initially but wane down later on, after stroke.
in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to receive lower extremity task-oriented training using a Motor Relearning Programme or Bobath-based treatment. Lower extremity spasticityInvoluntary muscle tightness and stiffness that can occur after a stroke. It is characterized by exaggerated deep tendon reflexes that interfere with muscular activity, gait, movement, or speech. Spasticity can increase initially but wane down later on, after stroke.
was measured by the Modified Ashworth Scale at 1 month, 3 months and 6 months. No significant between-group difference was found at either time point.
Note: The treatment did not have a specific ‘end-point’ and continued as long as was needed.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA 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. that lower-extremity task-oriented training is not more effective than a comparison intervention (Bobath-based treatment) in improving lower extremity spasticityInvoluntary muscle tightness and stiffness that can occur after a stroke. It is characterized by exaggerated deep tendon reflexes that interfere with muscular activity, gait, movement, or speech. Spasticity can increase initially but wane down later on, after stroke.
in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (van Vliet et al., 2005) and one quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
(Rose et al., 2011) investigated the effect of lower extremity task-oriented training on sensory impairment in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The high quality RCTA 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. (van Vliet et al., 2005) randomized patients to receive lower extremity task-oriented training using a Motor Relearning Programme or Bobath-based treatment. Sensory impairment was measured by the Nottingham Sensory Assessment at 1 month, 3 months and 6 months. No significant between-group difference was found at any time point.
Note: The treatment did not have a specific ‘end-point’ and continued as long as was needed.

The quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
(Rose et al., 2011) assigned patients to receive task-oriented mobility training or conventional rehabilitation. Sensory impairment was measured by the Fugl-Meyer Assessment (FMA; sensory scale) at post-treatment (discharge from hospital, average length of stay of 20 days). No significant between-group difference was found.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA 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. and one quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
that lower extremity task-oriented training is not more effective than a comparison intervention (Bobath-based treatment,conventional rehabilitation) in improving sensory impairment in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Two high quality RCTs (Richards et al., 1993; van Vliet et al., 2005) and one quasi-experimental study(Rose et al., 2011) investigated the effect of lower extremity task-oriented training on walking speed in patients with acute stroke.

The first high quality RCTA 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. (Richards et al., 1993) randomized patients to receive (i) early, intensive gait-focused task-oriented physical therapy, (ii) early, high-intensity conventional rehabilitation, or (iii) conventional rehabilitation. Walking speed was measured by the 6-Meter Walk Test (6MWT) at post-treatment (6 weeks) and at follow-up (3 and 6 months post-stroke). No significant between-group differences were found at any time points.

The second high quality RCTA 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. (van Vliet et al., 2005) randomized patients to receive lower extremity task-oriented training using a Motor Relearning Programme or Bobath-based treatment. Walking speed was measured by the 6MWT at 1 month, 3 months and 6 months. No significant between-group difference was found at any time point.

The quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
(Rose et al., 2011) assigned patients to receive task-oriented mobility training or conventional rehabilitation. Walking speed was measured by the 5-Meter Walk Test at post-treatment (discharge from hospital with mean length of stay of 20 days). A significant between-group difference was found favoring task-oriented training vs. conventional rehabilitation.

Conclusion: There is strong evidence (Level 1a) from two high quality RCTs that lower extremity task-oriented training is not more effective than comparison interventions (conventional rehabilitation, Bobath-based treatment) for improving walking speed in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: However, one quasi-experimental studyAn experimental study in which the participants are not randomized to receive treatments and as such the investigators lack control over allocation to interventions. This study design is inferior to a randomized controlled trial (RCT) but is valuable in answering research questions when an RCT is not possible either because of ethical constraints or logistic restraints.
found that lower-extremity task-oriented training is more effective than conventional rehabilitation for improving walking speed in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Two high quality RCTs (Marigold et al., 2005; Yang et al., 2006) and three fair quality RCTs (Dean et al., 2000; Kim et al., 2012; Choi & Kang, 2015) investigated the effect of lower extremity task-oriented training on balance in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The first high quality RCTA 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. (Marigold et al., 2005) randomized patients to receive lower extremity task-oriented training or a slow stretching and weight shifting program. Balance was measured by the Berg Balance Scale (BBS), and falls (forced due to platform translation), at post-treatment (10 weeks) and at follow-up (1 month); falls (unforced) were measured using monthly calendars from baseline up to 1 year later. There were no significant between-group differences in balance at any time points.

The second high quality RCTA 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. (Yang et al., 2006) randomized patients to receive task-oriented progressive resistant training or no therapy. Standing balance was measured by the Step Test at post-treatment (4 weeks). Significant between-group difference was found favoring task-oriented progressive resistant training vs. no therapy.

The first fair quality RCTA 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. (Dean et al., 2000) randomized patients to receive lower extremity task-oriented training or upper extremity task-oriented training. Standing balance was measured by the Step Test at post-treatment (4 weeks) and at follow-up (2 months). A significant between-group difference was found at any time point, favoring the lower extremity task-oriented training vs. upper extremity task-oriented training.

The second fair quality RCTA 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. (Kim et al., 2012) randomized patients to receive lower extremity task-oriented training with conventional physical therapy or conventional physical therapy alone. Balance was measured by the BBS at post-treatment (4 weeks). Significant between-group difference was found favoring lower extremity task-oriented training with conventional physical therapy vs. conventional physical therapy alone.

The third fair quality RCTA 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. Choi & Kang, 2015) randomized patients to receive either lower extremity task-oriented training or conventional physical therapy. Balance was measured by the BBS at post-treatment (4 weeks). Significant between-group difference was found favoring lower extremity task-oriented training vs. conventional physical therapy.

Conclusion: There is conflicting evidence (Level 4) regarding the effect of lower extremity task oriented training on balance in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. One high quality RCTA 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. and three fair quality RCTs found that lower extremity task-oriented training was more effective than comparison programs (upper extremity task-oriented training, conventional physical therapy) and no therapy for improving balance outcomes (Step Test, BBS). However, a second high quality RCTA 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. found no difference in balance (BBS, forced/unforced falls) between lower extremity task-oriented training and another lower extremity training program (slow stretching and weight shifting program).

Two high quality RCTs (Marigold et al., 2005, Mudge et al., 2009) investigated the effect of lower extremity task-oriented training on balance confidence in patients with chronic stroke.

The first high quality RCTA 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. (Marigold et al., 2005) randomized patients to receive lower extremity task-oriented training or a slow stretching and weight shifting program. Balance confidence was measured by the Activities-Specific Balance Confidence (ABC) Scale at post-treatment (10 weeks) and at 1-month follow-up. No significant between-group difference was found at any time point.

The second high quality RCTA 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. (Mudge et al., 2009) randomized patients to receive lower extremity task-oriented training or social/educational classes. Balance confidence was measured by the ABC Scale at post-treatment (4 weeks) and at 3-month follow-up. No significant between-group difference was found at any time point.

Conclusion: There is strong evidence (Level 1a) from two high quality RCTs that lower extremity task-oriented training is not more effective than comparison interventions (slow stretching and weight shifting program, social/educational classes) in improving balance confidence in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One fair quality RCT (Choi & Kang, 2015) investigated the effect of lower extremity task-oriented training on functional independence/activities of daily living (ADLs) in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCTA 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. randomized patients to receive lower extremity task-oriented training or conventional physical therapy. ADLs were measured by the Modified Barthel Index at post-treatment (4 weeks). Significant between-group difference was found favoring lower extremity task-oriented training vs. conventional physical therapy.

Conclusions: There is limited evidence (Level 2a) from one fair quality RCTA 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. that lower extremity task-oriented training is more effective than a comparison intervention (conventional physical therapy) in improving functional independence/ADLs in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Three high quality RCTs (Marigold et al., 2005; Yang et al., 2006; Mudge et al., 2009) and two fair quality RCTs (Dean et al., 2000; Kim et al., 2012) investigated the effect of lower extremity task-oriented training on functional mobility in patients with chronic stroke.

The first high quality RCT (Marigold et al., 2005) randomized patients to lower extremity task-oriented training or a slow stretching and weight shifting program. Functional mobility was measured by the Timed Up-and-Go Test (TUG) at post-treatment (10 weeks) and at follow-up (1 month). No significant between-group difference was found at any time point.

The second high quality RCTA 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. (Yang et al., 2006) randomized patients to receive task-oriented progressive resistant training or no therapy. Functional mobility was measured by the TUG at post-treatment (4 weeks). Significant between-group difference was found favoring task-oriented progressive resistant training vs. no therapy.

The third high quality RCTA 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. (Mudge et al., 2009) randomized patients to receive lower extremity task-oriented training or social/educational classes. Functional mobility was measured by the Rivermead Mobility Index at post-treatment (4 weeks) and at 3-month follow-up. While there was no significant between-group difference at post-treatment, results were significant at 3-month follow-up in favour of lower extremity task-oriented training vs. social/educational classes.

The first fair quality RCT (Dean et al., 2000) randomized patients to receive lower extremity task-oriented training or upper extremity task-oriented training. Functional mobility was measured by the TUG at post-treatment (4 weeks) and at follow-up (2 months). No significant between-group difference was found at any time point.

The second fair quality RCTA 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. (Kim et al., 2012) randomized patients to receive lower extremity task-oriented training with conventional physical therapy or conventional physical therapy alone. Functional mobility was measured by the TUG at post-treatment (4 weeks). No significant between-group difference was found.

Conclusion: There is conflicting evidence (Level 4) regarding the effect of lower extremity task-oriented training on functional mobility in the chronic stage of strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. recovery. Whereas one high quality RCTA 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. found that a lower extremity task-oriented training program was more effective than no intervention, one high quality RCTA 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. and two fair quality RCTs found that lower extremity task-oriented training was not more effective than comparison interventions (slow stretching and weight shifting program, upper extremity task-oriented training, conventional physical therapy) for improving functional mobility outcomes (TUG). A third highquality RCTA 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. found that lower extremity task-oriented training was not more effective than a comparison intervention (social/education classes) immediately post-treatment, but demonstrated long-term effectiveness.
Note: This study used a different measure of functional mobility (Rivermead Mobility Index).

Three high quality RCTs (Marigold et al., 2005; Yang et al., 2006; Jonsdottir et al., 2010) investigated the effect of lower extremity task-oriented training on gait parameters in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The first high quality RCTA 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. (Marigold et al., 2005) randomized patients to receive lower extremity task-oriented training or a slow stretching/weight-shifting program. GaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
parameters (step reaction time) were measured at baseline, post-treatment (10 weeks) and follow-up (1 month). Significant between-group differences were found across time points, favoring lower extremity task-oriented training vs. slow stretching and weight shifting program.

The second high quality RCT (Yang et al., 2006) randomized patients to receive task-oriented progressive resistant training or no therapy. GaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
parameters (velocity, cadence, stride length) were measured using the GAITRite system at post-treatment (4 weeks). Significant between-group differences were found for all gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
parameters, favoring task-oriented progressive resistant training vs. no therapy.

The third high quality RCTA 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. (Jonsdottir et al., 2010) randomized patients to receive either lower extremity task-oriented training using biofeedback or conventional rehabilitation. GaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
parameters (peak knee flexion during gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
swing, peak ankle power, and stride length) were measured at baseline and at post-treatment (7 weeks) and at follow-up (3 months). Significant between-group differences were found for gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
parameters (peak ankle power and stride length) across time points, favoring lower extremity task-oriented training using biofeedback vs. conventional rehabilitation.

Conclusion: There is strong evidence (Level 1a) from three high quality RCTs that lower extremity task-oriented training is more effective than comparison interventions (slow stretching and weight shifting program or conventional rehabilitation) and no therapy in improving gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
parameters in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (Marigold et al., 2005) investigated the effect of lower extremity task-oriented training on health-related quality of life in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality randomized patients to receive lower extremity task-oriented training or a slow stretching/weight-shifting program. Health-related quality of life was measured by the Nottingham Health Profile at baseline, at post-treatment (10 weeks) and at follow-up (1 month). No significant between-group differences were found across time points.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA 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. that lower extremity task-oriented training is not more effective than a comparison intervention (slow stretching/weight-shifting program) in improving health-related quality of life in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (Yang et al., 2006) investigated the effect of lower extremity task-oriented training on strength in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to receive task-oriented progressive resistant training or no therapy. Strength of the hip flexors/extensors, knee flexors/extensors and ankle dorsi/plantarflexors was measured by Jamar hand held dynamometer at post-treatment (4 weeks). Significant between-group differences were found across all measures of lower extremity strength, favoring lower extremity task-oriented training vs. no therapy.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA 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. that lower extremity task-oriented training is more effective than no therapy in improving lower extremity strength in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (Mudge et al., 2009) investigated the effect of lower extremity task-oriented training on physical activity in patients with chronic stroke. This high quality RCT randomized patients to receive lower extremity task-oriented training or social/educational classes. Physical activity was measured by the Physical Activity & Disability Scale and the StepWatch Activity Monitor (mean steps/day, peak activity index, steps/minute, % time inactive) at post-treatment (4 weeks) and at 3-month follow-up. No significant between-group differences were found at any time points.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA 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. that lower extremity task-oriented training is not more effective than a comparison intervention (social/educational classes) in increasing physical activity in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One fair quality RCT (Choi & Kang, 2015) investigated the effect of lower extremity task-oriented training on self-efficacy in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCT randomized patients to receive lower extremity task-oriented training or conventional physical therapy. Self-efficacy was measured by the Self-Efficacy Scale at post-treatment (4 weeks). Significant between-group difference was found favoring lower extremity task-oriented training vs. conventional physical therapy.

Conclusions: There is limited evidence (Level 2a) from one fair quality RCTA 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. that lower extremity task-oriented training is more effective than a comparison intervention (conventional physical therapy) in improving self-efficacy in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One fair quality RCT (Dean et al., 2000) investigated the effect of lower extremity task-oriented training on sit-to-stand impairment in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCT randomized patients to receive lower extremity task-oriented training or upper extremity task-oriented training. Sit-to-stand impairment was measured by the ground reaction AMTI force plate at post-treatment (4 weeks) and at follow-up (2 months). A significant between-group difference was found at any time point, favoring lower extremity task-oriented training vs. upper extremity task-oriented training.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA 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. that lower extremity task-oriented training is more effective than a comparison intervention (upper extremity task-oriented training) in improving the sit-to-stand impairment in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One fair quality RCT (Kim et al., 2012) investigated the effect of lower extremity task-oriented training on trunk motor impairmentLoss of strength and coordination, decrease in arm or leg movement
in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCT randomized patients to receive lower extremity task-oriented training with conventional physical therapy or conventional physical therapy alone. Trunk motor impairmentLoss of strength and coordination, decrease in arm or leg movement
was measured by the Trunk Impairment Scale (TIS – static sitting, dynamic sitting, coordination and total scores) at post-treatment (4 weeks). A significant between-group difference in trunk motor impairmentLoss of strength and coordination, decrease in arm or leg movement
(TIS total score only) was found, favoring lower extremity task-oriented training vs. conventional physical therapy alone.

Conclusions: There is limited evidence (Level 2a) from one fair quality RCT that lower extremity task-oriented training is more effective than a comparison intervention (conventional physical therapy alone) in improving trunk motor impairment in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Two high quality RCTs (Yang et al., 2006; Mudge et al., 2009) and one fair quality RCTA 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. (Dean et al., 2000) investigated the effect of lower extremity task-oriented training on walking endurance in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The first high quality RCTA 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. (Yang et al., 2006) randomized patients to receive task-oriented progressive resistant training or no therapy. Walking endurance was measured by the 6-Minute Walk Test (6MWT) at post-treatment (4 weeks). A significant between-group difference was found favoring lower extremity task-oriented training vs. no therapy.

The second high quality RCTA 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. (Mudge et al., 2009) randomized patients to receive lower extremity task-oriented training or social/educational classes. Walking endurance was measured by 6MWT at post-treatment (4 week) and at 3-month follow-up. A significant between-group difference was found at post-treatment, favoring lower extremity task-oriented training vs. social/educational classes; difference did not remain significant at 3-month follow-up.

The fair quality RCTA 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. (Dean et al., 2000) randomized patients to receive lower extremity task-oriented raining or upper extremity task-oriented training. Walking endurance was measured by 6MWT at post-treatment (4 weeks) and at follow-up (2 months). A significant between-group difference was found at any time point, favoring lower extremity task-oriented training vs. upper extremity task-oriented training.

Conclusion: There is strong evidence (Level 1a) from two high quality RCTs and one fair quality RCTA 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. that lower extremity task-oriented training is more effective than comparison interventions (no therapy, social/educational classes, upper extremity task-oriented training) in improving walking endurance in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Three high quality RCTs (Yang et al., 2006; Mudge et al., 2009; Jonsdottir et al., 2010) and two fair quality RCTs (Dean et al., 2000; Kim et al., 2012) investigated the effect of lower extremity task-oriented training on walking speed in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The first high quality RCTA 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. (Yang et al., 2006) randomized patients to receive task-oriented progressive resistant training or no therapy. Walking speed was measured using the GAITRite system at post-treatment (4 weeks). A significant between-group difference was found favoring lower extremity task-oriented training vs. no therapy.

The second high quality RCT (Mudge et al., 2009) randomized patients to receive lower extremity task-oriented training or social/educational classes. Walking speed was measured by the 10-Meter Walk Test (10MWT) at post-treatment (4 weeks) and at 3-month follow-up. While there were no significant between-group differences at post-treatment, differences became significant at 3-month follow-up, favoring lower extremity task-oriented training vs. social/educational classes.

The third high quality RCTA 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. (Jonsdottir et al., 2010) randomized patients to receive lower extremity task-oriented training using biofeedback or conventional rehabilitation. Walking speed was measured by the 8-Meter Walk Test (8MWT), without assistive devicesAssistive devices are any piece of equipment that you use to make your daily activities easier to perform.
, at baseline, post-treatment (7 weeks) and at 3-month follow-up. Significant between-group differences were found across time points, favoring lower extremity task oriented training vs. conventional rehabilitation.

The first fair quality RCTA 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. (Dean et al., 2000) randomized patients to receive lower extremity task-oriented training or upper extremity task-oriented training. Walking speed was measured by the 10MWT (with and without assistive device) at post-treatment (4 weeks) and at 2-month follow-up. A significant between-group difference in walking speed (without assistive device only) was found at any time point, favoring lower extremity task-oriented training vs. upper extremity task-oriented training.

The second fair quality RCTA 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. (Kim et al., 2012) randomized patients to receive lower extremity task-oriented training with conventional physical therapy or conventional physical therapy alone. Walking speed was measured by the 10MWT at post-treatment (4 weeks). A significant between-group difference was found favoring lower extremity task-oriented training with conventional physical therapy vs. conventional physical therapy alone.

Conclusion: There is strong evidence (Level 1a) from three high quality RCTs and two fair quality RCTs that lower extremity task-oriented training is more effective than comparison interventions (social/educational classes, conventional rehabilitation, upper extremity task-oriented training, physical therapy) and no therapy in improving walking speed in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (van de Port et al., 2012) investigated the effect of lower extremity task-oriented training on anxiety and depressionIllness involving the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood or a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression.
in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity task-oriented circuit training or conventional physical therapy. Anxiety and depressionIllness involving the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood or a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression.
was measured by the Hospital Anxiety and DepressionIllness involving the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood or a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression.
Scale (HADS) at post-treatment (12 weeks) and at 3-month follow-up. No significant between-group differences were found at either time points.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA 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. that lower extremity task-oriented training is not more effective than a comparison intervention (conventional physical therapy) in reducing anxiety and depression in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Five high quality RCTs (Blennerhassett & Dite 2004; McClellan & Ada, 2004; Salbach et al., 2004; van de Port et al., 2012; Kim et al., 2016) investigated the effect of lower extremity task-oriented training on balance in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The first high quality RCTA 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. (Blennerhassett & Dite 2004) randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity task-oriented training or upper-extremity task-oriented training; both groups received conventional rehabilitation. Balance was measured by the Step Test at post-treatment (4 weeks) and at 6-month follow-up. No significant between-group difference was found at either time point.

The second high quality RCTA 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. (McClellan & Ada, 2004) randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive home-based lower extremity task-oriented training or home-based upper extremity training. Balance on reaching was measured by the Functional Reach Test at post-treatment (6 weeks) and at 2-month follow-up. Significant between-group difference was found at any time point, favoring lower extremity task-oriented training vs. upper extremity training.

The third high quality RCTA 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. (Salbach et al., 2004) randomized patients with subacute/chronic stroke to receive lower extremity task-oriented training or upper extremity task-oriented training. Balance was measured by the Berg Balance Scale (BBS) at post-treatment (6 weeks). No significant between-group difference was found.

The fourth high quality RCTA 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. (van de Port et al., 2012) randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity task-oriented circuit training or conventional physical therapy. Balance was measured by the Timed Balance Test at post-treatment (12 weeks) and at 3-month follow-up. No significant between-group difference was found at either time point.

The fifth high quality RCTA 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. (Kim et al., 2016) randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive either task-oriented mobility circuit training or physical therapy based on neurodevelopmental therapy. Balance was measured by the BBS at post-treatment (4 weeks). No significant between-group difference was found.

Conclusion: There is strong evidence (Level 1a) from four high quality RCTs that lower extremity task-oriented training is not more effective than comparison interventions (upper-extremity task-oriented training, conventional physical therapy,physical therapy based on neurodevelopmental therapy) in improving balance in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: However, one high quality RCTA 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. found that lower extremity task-oriented training is more effective than comparison intervention (upper-extremity task-oriented training) in improving balance on reaching in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One secondary analysis by Salbach et al., 2005 – related to a high quality RCT (Salbach et al., 2004) – investigated the effect of lower extremity task-oriented training on balance confidence in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This secondary analysis revealed a significant between-group difference in average proportional change of balance self-efficacy (Activities-specific Balance Confidence Scale) at post-treatment (6 weeks), favoring lower extremity task-oriented training vs. upper extremity task-oriented training. In addition, the baseline level of depressive symptoms (Geriatric DepressionIllness involving the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood or a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression.
Scale) was found to be an effect modifier on change in balance confidence.

Conclusion: There is moderate evidence (Level 1b) from one secondary analysis of a high quality RCT that lower extremity task-oriented training is more effective than a comparison intervention (upper-extremity task-oriented training) in improving balance confidence in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One fair quality RCT (Barreca et al., 2004) investigated the effect of lower extremity task-oriented training on falls in patients with stroke. This fair quality RCTA 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. randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive task-oriented sit-to-stand training or recreational therapy; both groups received conventional rehabilitation. There was no significant between-group difference in the number of patients who fell during the study, measured from baseline to either the point at which independent sit-to-stand was achieved or discharge.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA 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. that lower extremity task-oriented training is not more effective than comparison intervention (recreational therapy) in reducing the incidence of falls in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (van de Port et al., 2012) investigated the effect of lower extremity task-oriented training on falls efficacy in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive either lower extremity task-oriented circuit training or conventional physical therapy. Falls efficacy was measured by the Falls Efficacy Scale at post-treatment (12 weeks) and at 3-month follow-up. No significant between-group difference was found at any time point.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA 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. that lower extremity task-oriented training is not more effective than comparison interventions (conventional physical therapy) in improving falls efficacy in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (van de Port et al., 2012) investigated the effect of lower extremity task-oriented training on fatigue (self-report) in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive either lower extremity task-oriented circuit training or conventional physical therapy. Fatigue (self-report) was measured by the Fatigue Severity Scale at post-treatment (12 weeks) and at 3-month follow-up. No significant between-group difference was found at any time point.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that lower extremity task-oriented training is not more effective than a comparison intervention (conventional physical therapy) in reducing fatigue (self-report) in patients with stroke.

One high quality RCT Kim et al., 2016) and one fair quality RCT (Kim et al., 2015b) investigated the effect of lower extremity task-oriented training on functional independence/ADLs in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The high quality RCT (Kim et al., 2016) randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive task-oriented mobility circuit training or physical therapy based on neurodevelopmental therapy. Functional independence/ADLs were measured by the Korean version of the Modified Barthel Index (m-BI) at post-treatment (4 weeks). No significant between-group difference was found.

The fair quality RCTA 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. (Kim et al., 2015b) randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive task-oriented training on a tilt table + conventional rehabilitation, standard tilt table training + conventional rehabilitation, or conventional rehabilitation alone. Functional independence/ADLs were measured by the Barthel Index (BI) at post-treatment (3 weeks). Significant between-group differences were found favoring task-oriented tilt table training vs. standard tilt table training; favoring task-oriented tilt table training vs. conventional rehabilitation alone; and favoring standard tilt table training vs. conventional rehabilitation alone.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA 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. that lower extremity task-oriented training is not more effective than a comparison intervention (physical therapy based on neurodevelopmental therapy) in improving functional independence/ADLs in patients with stroke.
Note: However, one fair quality RCTA 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. found that task-oriented training on a tilt table is more effective than comparison interventions (standard tilt table training, conventional rehabilitation alone) in improving functional independence/ADLs in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Four high quality RCTs (Blennerhassett & Dite 2004; Salbach et al., 2004; McClellan & Ada, 2004; van de Port et al., 2012) investigated the effect of lower extremity task-oriented training on functional mobility in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The first high quality RCT (Blennerhassett & Dite 2004) randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity task-oriented training or upper-extremity task-oriented training; both groups received conventional rehabilitation. Functional mobility was measured by the Timed Up-and-Go Test (TUG) at post-treatment (4 weeks) and at 6-month follow-up. No significant between-group difference was found at either time point.

The second high quality RCTA 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. (Salbach et al., 2004) randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity task-oriented training or upper extremity task-oriented training. Functional mobility was measured by the TUG at post-treatment (6 weeks). No significant between-group difference was found.

The third high quality RCTA 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. (McClellan & Ada, 2004) randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive home-based lower extremity task-oriented training or home-based upper extremity training. Functional mobility was measured by the Motor Assessment Scale – walking ability scale (item 5) at post-treatment (6 weeks) and at 2-month follow-up. No significant between-group difference was found at either time point.

The forth high quality RCTA 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. (van de Port et al., 2012) randomized patients with subacute/chronic stroke to receive lower extremity task-oriented circuit training or conventional physical therapy. Functional mobility was measured by the Rivermead Mobility Index, the TUG and the Functional AmbulationThe ability to walk, with or without the aid of appropriate assistive devices (such as canes or walkers), safely and sufficiently to carry out mobility-related activities of daily living (ADLs). From Perry et al (1995), functional ambulation is referred to as walking in parallell bars for exercise at a speed of about 10/cm per second.
Classification at post-treatment (12 weeks) and at 3-month follow-up. There were no significant between-group differences in any measure of functional mobility at either time points.

Conclusion: There is strong evidence (Level 1a) from four high quality RCTs that lower extremity task-oriented training is not more effective than comparison interventions (upper-extremity task-oriented training, conventional physical therapy) in improving functional mobility in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One fair quality RCT (Kim et al., 2015a) investigated the effect of lower extremity task-oriented training on gait parameters in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCTA 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. randomized patients with subacute / chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive task-oriented training on a tilt table, one-leg standing training on a tilt-table or standard tilt table training; all groups received conventional rehabilitation in conjunction with their respective interventions. GaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
parameters (velocity, cadence, stride length, gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
symmetry ratio, double support percentage) were measured at post-treatment (3 weeks) using the GAITRite system. There were significant between-group differences for all gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
parameters, favoring task-oriented tilt table training vs. one-leg standing training, and favoring task-oriented tilt table training vs. standard tilt table training. There were also significant between-group differences for some gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
parameters (velocity, cadence), favoring one-leg standing tilt table training vs. standard tilt table training.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA 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. that lower extremity task-oriented training with tilt table training is more effective than comparison interventions (one-leg tilt table training, standard tilt table training) in improving gaitparameters in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (McClellan & Ada, 2004) and one fair quality RCT (Barreca et al., 2004) investigated the effect of lower extremity task-oriented training on health-related quality of life in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The high quality RCT (McClellan & Ada, 2004) randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive home-based lower extremity task-oriented training or home-based upper extremity training. Health-related quality of life was measured by the Stroke Adapted Sickness Impact Profile at post-treatment (6 weeks) and at 2-month follow-up. No significant between-group difference was found at either time point.

The fair quality RCT (Barreca et al., 2004) randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive task-oriented sit-to-stand training or recreational therapy; both groups received conventional rehabilitation. Health-related quality of life was measured by the Global Rating Scale and the Darmouth Primary Care Cooperative Information Project at post-treatment (4 months). There were no significant between-group differences in any measures.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA 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. and one fair quality RCTA 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. that lower extremity task-oriented training is not more effective than comparison interventions (upper extremity training, recreational therapy) in improving health-quality of life among patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (van de Port et al., 2012) investigated the effect of lower extremity task-oriented training on instrumental activities of daily living (IADLs) in patients with stroke. This high quality RCT randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity task-oriented circuit training or conventional physical therapy. IADLs were measured by the Nottingham Extended ADL (NEADL – mobility, kitchen, domestic, leisure scores) at post-treatment (12 weeks) and at 3-month follow-up. There was a significant between-group difference in one measure of IADLs (NEADL – Leisure) at post-treatment, favoring conventional physical therapy vs. task-oriented mobility circuit training. This did not remain significant at follow-up.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that lower extremity lower extremity task-oriented training is not more effective than a comparison intervention (conventional physical therapy) in improving IADLs in patients with stroke.
Note: In fact, conventional physical therapy was found to be more effective than lower extremity task-oriented circuit training in improving one domain of IADLs (leisure) in the short-term.

Two high quality RCTs (van de Port et al., 2012, Kim et al., 2016) and one fair quality RCT (Kim et al., 2015b) investigated the effect of lower extremity task-oriented training on lower extremity motor function in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The first high quality RCT (van de Port et al., 2012) randomized patients with subacute/chronic to receive lower extremity task-oriented circuit training or conventional physical therapy. Lower extremity motor function was measured by the Motricity Index (MI) – Leg score at post-treatment (12 weeks) and at 3-month follow-up (3 months). No significant between-group difference was found at either time point.

The second high quality RCT (Kim et al., 2016) randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive task-oriented mobility circuit training or physical therapy based on neurodevelopmental therapy. Lower extremity motor function was measured by the Fugl-Meyer Assessment (FMA – lower extremity subscaleMany measurement instruments are multidimensional and are designed to measure more than one construct or more than one domain of a single construct. In such instances subscales can be constructed in which the various items from a scale are grouped into subscales. Although a subscale could consist of a single item, in most cases subscales consist of multiple individual items that have been combined into a composite score (National Multiple Sclerosis Society).
) at post-treatment (4 weeks). No significant between-group difference was found.

The fair quality RCTA 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. (Kim et al., 2015b) randomized patients with acute/subacute stroke to receive task-oriented training on a tilt table + conventional rehabilitation, standard tilt table training + conventional rehabilitation, or conventional rehabilitation alone. Lower extremity motor function was measured by the FMA – lower extremity subscaleMany measurement instruments are multidimensional and are designed to measure more than one construct or more than one domain of a single construct. In such instances subscales can be constructed in which the various items from a scale are grouped into subscales. Although a subscale could consist of a single item, in most cases subscales consist of multiple individual items that have been combined into a composite score (National Multiple Sclerosis Society).
at post-treatment (3 weeks). Significant between-group differences were found favoring task-oriented tilt table training vs. standard tilt table training; favoring task-oriented tilt table training vs. conventional rehabilitation alone; and favoring standard tilt table training vs. conventional rehabilitation alone.

Conclusion: There is strong evidence (Level 1a) from two high quality RCTs that lower extremity task-oriented training is not more effective than a comparison intervention (conventional physical therapy,physical therapy based on neurodevelopmental therapy) in improving lower extremity motor function in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: However, one fair quality RCTA 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. found that task-oriented training on a tilt table is more effective than comparison interventions (standard tilt table training, conventional rehabilitation alone) in improving lower extremity motor function in patients with stroke.

One fair quality RCT (Kim et al., 2015b) investigated the effect of lower extremity task-oriented training on muscle activation in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCT randomized patients with acute / subacute stroke to receive task-oriented training on a tilt table + conventional rehabilitation, standard tilt table training + conventional rehabilitation, or conventional rehabilitation alone. Muscle activations (biceps femoris, medial gastrocnemius, rectus femoris, tibialis anterior of the affected and unaffected lower extremities) were measured by the electromyography (EMG) at post-treatment (3 weeks). Significant between-group differences were found (affected and less affected biceps femoris; affected and less affected medial gastrocnemius; less affected rectus femoris), favoring task-oriented tilt table training vs. standard tilt table training, and favoring task-oriented tilt table training vs. conventional rehabilitation alone.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that lower extremity task-oriented training on a tilt table is more effective than comparison interventions (standard tilt table training, conventional rehabilitation alone) in improving muscle activation in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One fair quality RCT (Kim et al., 2015a) investigated the effect of lower extremity task-oriented training on lower extremity muscle strength in patients with stroke. This fair quality RCT randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive task-oriented training on a tilt table, one-leg standing training on a tilt table, or standard tilt table training; all groups also received conventional rehabilitation. Lower extremity muscle strength (hip flexors/extensors, knee flexors/extensors, ankle dorsi/plantarflexors) was measured by handheld dynamometer at post-treatment (3 weeks). There were significant between-group differences in lower extremity muscle strength (hip flexors/extensors, knee flexors/extensors, ankle dorsi/plantarflexors), favoring task-oriented tilt table training vs. one-leg standing tilt table training, and favoring task-oriented tilt table training vs. standard tilt table training. There were also significant between-group differences (hip flexors/extensors only), favoring one-leg standing tilt table training vs. standard tilt table training.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA 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. that lower extremity task-oriented training on a tilt table is more effective than comparison interventions (one-leg standing training on a tilt table, standard tilt table training) in improving lower extremity muscle strength in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One fair quality RCT (Barreca et al., 2004) investigated the effect of lower extremity task-oriented training on sit-to-stand maneuver in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCTA 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. randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive task-oriented sit-to-stand training or recreational therapy; both groups received conventional rehabilitation. Sit-to-stand maneuver was measured as the number of participants who were successful in standing up twice, without hands, from a 16-inch mat surface for 2 consecutive days. Sit-to-stand maneuver was also measured as the mean number of daily sit-to-stand repetitions performed until the end of the study defined as either the point at which independent sit-to-stand was achieved or discharge. There were significant between-group differences on both measures of sit-to-stand, favoring task-oriented training vs. recreational therapy.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that task-oriented sit-to-stand training is more effective than a comparison intervention (recreational therapy) in improving the sit-to-stand maneuver in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (van de Port et al., 2012) investigated the effects of lower extremity task-oriented training on stairs competence in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity task-oriented circuit training or conventional physical therapy. Stairs competence was measured by the Modified Stairs Test at post-treatment (12 weeks) and at 3-month follow-up. There was a significant between-group difference at post-treatment, favoring lower extremity task-oriented circuit training vs. conventional physical therapy. This difference did not remain significant at follow-up.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that lower extremity task-oriented training is more effective, in short term, than a comparison intervention (conventional physical therapy) in improving stairs competence in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (van de Port et al., 2012) investigated the effect of lower extremity task-oriented training on stroke outcomes in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA 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. randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity task-oriented circuit training or conventional physical therapy. StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. outcomes were measured by the Stroke Impact Scale (SIS) – Mobility, Strength, Memory/Thinking, Emotion, Communication, ADLs/IADLs, Hand function, ParticipationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. and StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. recovery scores at post-treatment (12 weeks) and at 3-month follow-up. Significant between-group difference was found in one measure of stroke outcomes (SIS – memory/thinking) at post-treatment only, favoring conventional physical therapy vs. task-oriented mobility training.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that lower extremity task-oriented training is not more effective than a comparison intervention (conventional physical therapy) in improving strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. outcomes of patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: In fact, conventional physical therapy was found to be more effective, in short term, than lower extremity task-oriented training on one measure of stroke outcomes (memory/thinking).

One fair quality RCT (Kim et al., 2015b) investigated the effect of lower extremity task-oriented training on stroke severity in patients with stroke. This fair quality RCT randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive task-oriented training on a tilt table + conventional rehabilitation, standard tilt table training + conventional rehabilitation, or conventional rehabilitation alone. StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. severity was measured by the National Institutes of Health StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. Scale (NIHSS) at post-treatment (3 weeks). Significant between-group differences were found favoring task-oriented tilt table training vs. standard tilt table training; favoring task-oriented tilt table training vs. conventional rehabilitation alone; and favoring standard tilt table training vs. conventional rehabilitation alone.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA 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. that lower extremity task-oriented training on a tilt table is more effective than comparison interventions (standard tilt table training, conventional rehabilitation alone) in improving strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. severity in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Four high quality RCTs (Blennerhassett & Dite 2004; Salbach et al., 2004; van de Port et al., 2012; Kim et al., 2016) investigated the effect of lower extremity task-oriented training on walking endurance in patients with stroke.

The first high quality RCT (Blennerhassett & Dite 2004) randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity task-oriented training or upper-extremity task-oriented training; both groups received conventional rehabilitation. Walking endurance was measured by the 6-Minute Walk Test (6MWT) at post-treatment (4 weeks) and 6-month follow-up. There was a significant between-group difference in walking endurance at post-treatment, favoring lower extremity task-oriented training vs. upper extremity task oriented training. This difference did not remain significant at follow-up.

The second high quality RCT (Salbach et al., 2004) randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity task-oriented training or upper extremity task-oriented training. Walking endurance was measured by the 6MWT at post-treatment (6 weeks). Significant between-group difference was found favoring lower extremity task-oriented training vs. upper extremity task-oriented training.

The third high quality RCTA 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. (van de Port et al., 2012) randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity task-oriented circuit training or conventional physical therapy. Walking endurance was measured by the 6MWT at post-treatment (12 weeks) and at 3-month follow-up. Significant between-group difference was found at post-treatment, favoring lower extremity task-oriented circuit training vs. conventional physical therapy. This difference did not remain significant at follow-up.

The fourth high quality RCTA 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. (Kim et al., 2016) randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive task-oriented mobility circuit training or physical therapy based on neurodevelopmental therapy. Walking endurance was measured by the 6MWT at post-treatment (4 weeks). No significant between-group difference was found.

Conclusion: There is strong evidence (Level 1a) from three high quality RCTs that lower extremity task-oriented training is more effective than comparison interventions (upper extremity task-oriented training, conventional physical therapy) in improving walking endurance among patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Note: However, a fourth high quality RCTA 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. found no difference in walking endurance between task-oriented mobility circuit training and physical therapy based on neurodevelopmental therapy.

Two high quality RCTs (Salbach et al., 2004; van de Port et al., 2012) and one fair quality RCT (Kim et al., 2015a) investigated the effect of lower extremity task-oriented training on walking speed in patients with subacute/chronic stroke.

The first high quality RCT (Salbach et al., 2004) randomized patients to receive lower extremity task-oriented training or upper extremity task-oriented training. Walking speed was measured by the 5-Meter Walk Test (5MWT) maximal and comfortable speed scores at post-treatment (6 weeks). Significant between-group differences in both maximal and comfortable walking speeds were found, favoring lower extremity task-oriented training vs. upper extremity task-oriented training.

The second high quality RCT (van de Port et al., 2012) randomized patients to receive lower extremity task-oriented circuit training or conventional physical therapy. Walking speed was measured by the 5-Meter Comfortable Walking Speed Test at post-treatment (12 weeks) and at 3-month follow-up. Significant between-group difference was found at any time point, favoring lower extremity task-oriented circuit training vs. conventional physical therapy.

The fair quality RCT (Kim et al., 2015a) randomized patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive task-oriented training on a tilt table, one-leg standing training on a tilt-table or standard tilt table training; all groups received conventional rehabilitation in conjunction with their respective interventions. Walking speed was measured at post-treatment (3 weeks) using the GAITRite system. Significant between-group differences were found favoring task-oriented tilt table training vs. one-leg standing training; favoring task-oriented tilt table training vs. standard tilt table training; and favoring one-leg standing tilt table training vs. standard tilt table training.

Conclusion: There is strong evidence (Level 1a) from two high quality RCTs and one fairquality RCTA 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. that lower extremity task-oriented training is more effective than comparison interventions (upper extremity task-oriented training, conventional physical therapy,one-leg standing training on a tilt-table, standard tilt table training) in improving walking speed in patients with subacute/chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..