Progressive task-oriented circuit training after stroke
The aim of this pilot study was to determine the effects in terms of walking competency, therapy intensity in hours of therapy and costs of walking related therapies after stroke between patients allocated to the experimental group that received a Task-oriented Circuit Class Training (CCT) program and the control group that received usual care for a period of 12 weeks.
54 patients were stratified by 3 rehabilitation centres and were included into the study when they had completed an inpatient rehabilitation period. Patients were subsequently randomized to (i) Task-oriented CCT focusing on gait practice and functional gait-related tasks; or (ii) usual care designed to improve standing balance control, physical condition and gait performance . The SIS 3.0 mobility domain was used as primary outcome measure to determine the effect. Therapy intensity was determined for both groups and cost-analyses were performed in order to compare the direct medical costs and direct non-medical costs of the interventions between both groups. Analyses were carried out using non-parametrical statistics.
No significant results were found for effects between the experimental and control group (Median = 2.0, [IQR = 0-4] vs. Median = 2.0, [IQR = 0-8.25], p = 0.433). The experimental group had a higher therapy intensity than the control group (median 42 [IQR = 34.7-63.5] vs. 25.5 [IQR = 14.4-38.5], p = 0.001). Costs were not significantly different between both groups (Mean = 3,395.1 [SD = 1,337] vs. Mean = 4,008.3 [SD = 1,718],
p = 0.306).
Therapy intensity was significantly higher for the Task-oriented CCT group compared with usual care. Task-oriented CCT and usual care were found to be equally effective and equally expensive treatments for patients after stroke in this pilot study.