Circuit class therapy for improving mobility after stroke

Abstract

Stroke is a major cause of increased dependence for survivors in many activities of daily life, including the ability to walk and negotiate our usual environments. Intensive rehabilitation, with time spent practising specific tasks or functions under supervision, is very beneficial but achieving the sufficient amount of therapy time can be difficult if there is always a one staff to one client ratio. Circuit class therapy offers people with stroke the chance to practise meaningful functions in a group setting with the supervision of staff to give feedback and to progress the training. We found six studies involving 292 participants that compared this kind of rehabilitation to usual care or sham rehabilitation. All the trials reported benefits of circuit classes for improving the person's mobility. More specifically, we combined the results from the studies and found that the classes were more effective in improving the person's ability to walk further, longer or faster and to balance more easily and confidently when compared to other types of exercise. Also, people receiving the classes went home from inpatient rehabilitation earlier than the comparison groups. There were no increased risks of falling related to participating in the circuit classes. We are recommending people can attend circuit class therapy after stroke to achieve benefits in their ability to walk and balance. However, more research is needed to see if it works for all people at any stage or severity after stroke and if some tasks are better to practise than others.