This study examined the feasibility of using implicit and explicit learning approaches during gait rehabilitation in the early phase following stroke. It was a double blind trial (participants and assessors) using a matched pairs design. Participants were recruited from an acute stroke unit, and were randomised to receive gait rehabilitation over three consecutive days using either an implicit or explicit approach. Guidelines for each were developed empirically, including differences in the amount, timing, and attentional focus of therapists' verbal communication. Sessions were recorded and their content analysed to establish concordance with the guidance. Clinical measures were taken at baseline and 24 hours post intervention using the Berg Balance Scale and the Step Test. Therapists were able to adhere to the guidance. Both approaches were found to be acceptable to both patients and therapists. The findings will be used to design an appropriately powered RCT.
- Frequent instructions/feedback and an Internal Focus of Attention Other
ARM 1: Kind: Experimental Label: Explicit Learning Description: Physiotherapy delivered based on explicit treatment guidance - achieved primarily by giving frequent verbal coaching statements and promoting an internal focus of attention.
- Minimal instructions/feedback and an External Focus of Attention Other
ARM 1: Kind: Experimental Label: Implicit Learning Description: Physiotherapy delivered based on implicit treatment guidance - achieved primarily by reducing the frequency of verbal coaching statements and promoting an external focus of attention.
- Allocation: Randomized
- Masking: Double Blind (Subject, Outcomes Assessor)
- Purpose: Treatment
- Intervention: Parallel Assignment
|Type||Measure||Time Frame||Safety Issue|
|Primary||Berg Balance Scale||24 hours post final treatment session||No|
|Secondary||Step Test||24 hours post final treatment session||No|