Additionally, as is usual with trials of complex interventions, the outcome measures were not the same. This meant that we had to calculate a standardised mean difference from the meta-analysis, which is less clinically useful than a mean difference. Finally, only half of the trials measured the outcomes some time after the cessation of intervention. There is a need for a large high quality trial with adequate power and follow-up to investigate the effect of biofeedback in this population. In conclusion, this systematic review provides evidence that

augmenting feedback through the use of biofeedback is superior to usual therapy/placebo at improving lower limb activities in people after stroke. Importantly, it appears superior to therapist feedback. Furthermore, these benefits are largely maintained in the longer term. Given that many biofeedback CHIR-99021 molecular weight machines are relatively inexpensive, KU-55933 molecular weight biofeedback could be utilised more widely in clinical practice. The authors gratefully acknowledge Tien-Hsin Chang, Oktay Irmak, Helen Preston, J Rebecca Winbom, and Nikki Yang for assistance with translation. We would also like to thank Domenico Intiso and

Johanna Jondottir for providing us with additional information and data. “
“Chronic heart failure is characterised by dyspnoea, fatigue, and exercise intolerance. It is an increasingly common public health problem that leads to a poor prognosis and is associated with increased morbidity and decreased quality of life (Bennett et al 2003, Gwadry-Sridhar et al 2004). Some previous studies have

demonstrated that co-existing psychological conditions such as anxiety or depression are common among people with chronic heart failure in the community. These concomitant psychological conditions may lead to deterioration in the health of people with chronic heart failure and increase the risk of adverse outcomes (Friedmann et al 2006, Haworth et al 2005, Holzapfel et al 2009, Rumsfeld et al 2003, Tsuchihashi-Makaya et al 2009). Anxiety is also more likely as chronic heart disease becomes more severe on the New York Heart Association classification Vasopressin Receptor system (Haworth et al 2005). Quality of life might also be affected by these psychological conditions in people with chronic heart failure. However, the relationship that anxiety and depression have with quality of life and physical function remains to be determined. Exercise improves depression and anxiety scores in the general population and in some clinical populations (Herring et al 2010, Mead et al 2009). Several studies have investigated the psychological changes after exercise training in chronic heart failure patients (Koukouvou et al 2004, Kulcu et al 2007, Radzewitz et al 2002). However, the results are inconsistent.