Everything here should be publicly available with corresponding stroke protocols to accomplish them. But that won't occur because we have NO stroke leadership. You'll just have to hope that your doctor/therapist knows how to competently reproduce the interventions that were done in the research cited. With no link from this summary to the research this is actually pretty useless.
HAH! You're fucking screwed.
http://ebrsr.com/sites/default/files/CHapter-9_Mobility-and-Lower-Extrem_FINAL_16ed.pdf
9.11
Summary
1.
There is strong (Level 1a) evidence
that the Bobath approach is not superior to other therapy approaches.
2.
There is conflicting (Level 4)
evidence that the Motor Learning Approach is superior to the Bobath approach
for achieving improvements in functional outcome. There is moderate (Level 1b)
evidence that a Motor Learning Approach reduces length of
hospital stay.
3.
There is strong (Level 1a) evidence
that the Motor Learning Approach is superior to placebo and moderate (Level 1b)
evidence that it is superior to a conventional physiotherapy approach for
achieving improvements in functional outcome.
4.
There is strong (Level 1a) evidence
that augmented physical therapy is associated with improvements in gait.
However, there is also strong (Level 1a) evidence that the beneficial effect is
not maintained once therapy has ceased.
5.
There is strong (Level 1a) evidence
that balance training post stroke improves outcomes, although some treatment
approaches are more effective than others.
6. There is strong (Level 1a)
evidence that task-specific gait training techniques can be used to improve
gait post stroke.
7. There is strong (Level 1a)
evidence that treadmill training (without body weight support) can improve gait
velocity in ambulatory patients in the chronic stage of stroke.
8. There is conflicting (Level 4)
evidence that the combination of partial body weight support and treadmill
training results in improved gait performance compared with other physiotherapy
interventions.
9. There is strong (Level 1a)
evidence that virtual reality training can be used to enhance gait recovery
following stroke.
10. There is strong (Level 1a)
evidence that a variety of biofeedback methods that employ visual or auditory feedback
can improve measures of a gait and balance.
11. There is moderate (Level 1a)
evidence that bilateral leg training does not significantly improve lower-limb
motor function.
12. There is moderate (Level 1a)
evidence that mental practice improves sit to stand performance.
13. There is conflicting (Level 4)
evidence that strength training results in improvements in ADL performance,
distance walked or gait speed.
14. There is strong (Level 1a)
evidence that while cardiovascular training post stroke improves level of
physical fitness and gait performance; it does not result in additional improvement
in ADL performance.
15. There is moderate (Level 1b)
evidence, based on one “good” but likely underpowered RCT, that encouraging
hemiplegic stroke patients to propel their own wheelchair does not have an
impact on a variety of functional outcomes.
16. There is limited (level 2)
evidence that use of canes is associated with improved functional mobility.
17. There is moderate (Level 1b)
evidence that a quad cane is more effective than a standard cane in reducing
postural sway.
18. There is strong (Level 1a)
evidence that dynamic or standard AFOs can improve elements of gait.
19. There is moderate (Level 1b)
evidence that an AFO when combined with posterior tibial nerve deinnervation,
improves gait outcomes in hemiplegic stroke patients.
20. There is conflicting (Level 4)
evidence that robotic devices are superior to conventional gait training in the
improvement of functional walking performance.
21. There is strong (Level 1a)
evidence that TENS treatment can decrease spasticity in the chronic stage of
stroke.
22. There is strong (Level 1a)
evidence that FES and gait retraining results in improvements in hemiplegic
gait.
23. There is conflicting (Level 4)
evidence that amphetamines improve motor recovery and/or functional outcomes.
24. There is moderate (Level 1b)
evidence that methylphenidate helps to improve performance on ADL following
stroke.
25. There is limited (Level 2)
evidence that L-DOPS improves functional outcomes post stroke over the short-term.
26. There is moderate (Level 1b)
evidence that Levodopa improves motor recovery.
27. There is moderate (Level 1b)
evidence that ropinirole is no more effective than placebo at increasing gait
speed post stroke.
28. There is moderate (Level 1b)
evidence that citalopram can improve neurological status following stroke.
29. There is conflicting (Level 4)
evidence that fluoxetine can enhance motor recovery following stroke.
30. There is moderate (Level 1b)
evidence that Almitrine + Raubasine improves functional outcomes post stroke.
31. There is strong (Level 1a)
evidence that piracetam does not improve neurological status or ADL performance
following stroke.
32. There is moderate (level 1b)
evidence that both a tilt table and night splint effectively prevent ankle
contracture in the early period following stroke.
33. There is strong (Level 1a)
evidence that treatment with Botulinum toxin reduces lower-limb spasticity.
34. There is conflicting (Level 4)
evidence whether botulinum toxin improves functional outcomes.
35.There is strong(Level 1a)
evidence that treatment with Botulinum toxin + casting can reduce spasticity
following stroke.
36.There is moderate (Level 1b)
evidence that a single injection of either phenol or ethyl alcohol can reduce
spasticity for up to 6 months.
37. There is conflicting (Level 4)
evidence that Dantrolene sodium is effective in treating post-stroke spasticity
compared to placebo.
38. There is moderate (Level 1b)
evidence that ketazolam, diazepam and tolperisone are more effective when
compared to placebo in treating post-stroke spasticity.
39. There is limited (Level 2)
evidence that Tizanidine is not superior to oral Baclofen.
40. There is moderate (Level 1b)
evidence that Tolperisone reduces spasticity.
41. Based on the results from one
RCT there is moderate (Level 1b) evidence that intrathecal baclofen can reduce
spasticity in the chronic stages of stroke.
42. There is strong (level 1a)
evidence that electrical stimulation can reduce ankle plantarflexion spasticity
post stroke.
43. There is moderate (level 1b)
evidence that therapeutic ultrasound can reduce alpha motor neuron excitability
associated with ankle plantarflexor spasticity.
44. There is moderate (Level 1b)
evidence that a single session of isokinetic or isotonic muscle stretch does
not improve measures of gait.
