Deans' stroke musings: Effects of circuit training as alternative to usual physiotherapy after stroke: randomised controlled trial

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, February 28, 2016

Effects of circuit training as alternative to usual physiotherapy after stroke: randomised controlled trial

No idea what the hell this is. This is totally useless unless your doctor contacts the researchers for the stroke protocol.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349299/

Ingrid G L van de Port, assistant professor,¹ Lotte E G Wevers, PhD student,¹ Eline Lindeman, professor,¹ and Gert Kwakkel, professor^1,²

Author information ► Article notes ► Copyright and License information ►

This article has been cited by other articles in PMC.

Abstract

Objective To analyse the effect of task oriented circuit training compared with usual physiotherapy in terms of self reported walking competency for patients with stroke discharged from a rehabilitation centre to their own home.

Design Randomised controlled trial with follow-up to 24 weeks.

Setting Multicentre trial in nine outpatient rehabilitation centres in the Netherlands

Participants Patients with stroke who were able to walk a minimum of 10 m without physical assistance and were discharged from inpatient rehabilitation to an outpatient rehabilitation clinic. Patients were randomly allocated to circuit training or usual physiotherapy, after stratification by rehabilitation centre, with an online randomisation procedure.

Intervention Patients in the intervention group received circuit training in 90 minute sessions twice a week for 12 weeks. The training included eight different workstations in a gym and was intended to improve performance in tasks relating to walking competency. The control group received usual outpatient physiotherapy.

Main outcome measures The primary outcome was the mobility domain of the stroke impact scale (SIS, version 3.0). Secondary outcomes were standing balance, self reported abilities, gait speed, walking distance, stair climbing, instrumental activities of daily living, fatigue, anxiety, and depression. Differences between groups were analysed according to the intention to treat principle. All outcomes were assessed by blinded observers in a repeated measurement design lasting 24 weeks.

Results 126 patients were included in the circuit training group and 124 in the usual care group (control), with data from 125 and 117, respectively, available for analysis. One patient from the circuit training group and seven from the control group dropped out. Circuit training was a safe intervention, and no serious adverse events were reported. There were no significant differences between groups for the stroke impact scale mobility domain (β=0.05 (SE 0.68), P=0.943) at 12 weeks. Circuit training was associated with significantly higher scores in terms of gait speed (0.09 m/s (SE 0.02), P<0.001), walking distance (20.0 m (SE 7.4), P=0.007), and modified stairs test (−1.6 s (SE 0.7), P=0.015). There were no significant differences between groups for the other secondary outcomes, except for the leisure domain of the Nottingham extended activities of daily living and the memory and thinking domain of the stroke impact scale. With the exception of gait speed (−0.04 m/s (SE 0.02), P=0.040), there were no significant differences between groups at follow-up.

Conclusion Task oriented circuit training can safely replace usual physiotherapy for patients with stroke who are discharged from inpatient rehabilitation to the community and need further training in gait and gait related activities as an outpatient.

Trial registration Dutch Trial Register (NTR1534).

Two of the doctors being interviewed here, still no help in understanding this at all.

Circuit class training in stroke rehabilitation

Anne Moseley talked to Dr Jannette Blennerhassett and Dr Wayne Dite (Austin Health Royal Talbot Rehabilitation Centre, Australia) whose trial evaluating circuit class training in stroke rehabilitation is one of the most significant trials in physiotherapy.