Article

This study aimed to determine the effectiveness of current
interventions to improve real-world walking for people with stroke and
specifically whether benefits are sustained. DATA SOURCES: EBSCO Megafile, AMED,
Cochrane, Scopus, PEDRO, OTSeeker and Psychbite databases were searched to
identify relevant studies. METHODS: Proximity searching with keywords such
as ambulat*, walk*, gait, mobility*, activit* was used. Randomized controlled
trials that used measures of real-world walking were included.
Two reviewers
independently assessed methodological quality using the Cochrane Risk of Bias
Tool and extracted the data. RESULTS: Nine studies fitting the inclusion criteria
were identified, most of high quality. A positive effect overall was found
indicating a small effect of interventions on real-world walking (SMD 0.29 (0.17,
0.41)). Five studies provided follow-up data at >3-6 months, which demonstrated
sustained benefits (SMD 0.32 (0.16, 0.48)). Subgroup analysis revealed studies
using exercise alone were not effective (SMD 0.19 (-0.11, 0.49)), but those
incorporating behavioural change techniques (SMD 0.27 (0.12, 0.41)) were.
CONCLUSIONS: A small but significant effect was found for current interventions
and benefits can be sustained. Interventions that include behaviour change
techniques appear more effective at improving real-world walking habits than
exercise alone.

Langue : ANGLAIS