Effects of Task-Oriented Circuit Class Training on Walking Competency After Stroke

Abstract

Background and Purpose-There is increasing interest in the potential benefits of circuit class training after stroke, but its effectiveness is uncertain. Our aim was to systematically review randomized, controlled trials of task-oriented circuit class training on gait and gait-related activities in patients with stroke. Methods-A computer-aided literature search was performed to identify randomized, controlled trials in which the experimental group received task-oriented circuit class training focusing on the lower limb. Studies published up to March 2008 were included. The methodological quality of each study was assessed and studies with the same outcome variable were pooled by calculating the summary effect sizes using fixed or random effects models. Results-Six of the 445 studies screened, comprising 307 participants, were included. Physiotherapy Evidence Database scores ranged from 4 to 8 points with a median of 7.5 points. The meta-analysis demonstrated significant homogeneous summary effect sizes in favor of task-oriented circuit class training for walking distance (0.43; 95% CI, 0.17 to 0.68; PϽ0.001), gait speed (0.35; 95% CI, 0.08 to 0.62; Pϭ0.012), and a timed up-and-go test (0.26; 95% CI, 0.00 to 0.51; Pϭ0.047). Nonsignificant summary effect sizes in favor of task-oriented circuit class training were found for the step test and balance control. Conclusions-This meta-analysis supports the use of task-oriented circuit class training to improve gait and gait-related activities in patients with chronic stroke. Further research is needed to investigate the cost-effectiveness and its effects in the subacute phase after stroke, taking comorbidity into account, and to investigate how to help people maintain and improve their physical abilities after their rehabilitation program ends.

The Effects of Dual-Motor Task Training on the Gait Ability of Chronic Stroke Patients

“…In this study, the consecutive tasks that were applied as an intervention for chronic stroke patients included rising from a from after a sitting posture, for symmetry and active control of the lower limbs and the trunk, and slowly walking forward, sideways, and backward, for active control of the lower limbs and various muscle activities. Furthermore in order to train active lower-limb control and improve gait velocity and coordination, intensive training that included obstacle walking, such as ascending stairs or a slope, and walking backwards on flat ground at maximal speed was conducted 14,17,18) . In addition, this study had subjects perform continuous motions encounterd in daily life, such as holding a cup while standing up from a sitting position, walking while holding a 100 g weight, and climbing up and down a ramp or stairs while moving a cup as described in previous studies of dual-task training the usefulness of which was demonstrated in walking while making a phone call using a cellular phone or holding objects 19) .…”

Patient Preference for Community-based Rehabilitation Programs after Stroke

“…The potential benefits of task-related circuit training after stroke is uncertain 19) , but the program was selected as a good model of a CBR program. According to Salbach 18) , a task-orientated intervention enhances the walking distance and speed of patients who have suffered a stroke.…”

“…Further, Lee 15) reported that factors related to motivation in the rehabilitation of patients after a stroke are financial stress, depression, occupation, conjugal affection, and education. Also, the types of CBR programs that have been carried out have mainly been group exercise programs 8,9) , task oriented circuit programs 10,[16][17][18][19] , home visiting programs and the studies of the effects of those programs; but, analyse of these programs has not been conducted.…”

Group Circuit Class Therapy for Stroke Survivors – A Review of the Evidence and Clinical Implications

“…This small pilot study was the first to describe the effectiveness of group circuit class therapy with regard to improved motor function in people after stroke. Since that time the evidence base has continued to grow and there are now two published systematic reviews on the topic Wevers et al, 2009). …”