Circuit class therapy versus individual physiotherapy sessions during inpatient stroke rehabilitation: a controlled trial. Circuit Class or Seven-Day Therapy for Increasing Intensity of Rehabilitation after Stroke: Protocol of the CIRCIT Trial Group Balance Skills Class for People with Chronic Stroke: A Case Series Feasibility and Effectiveness of Circuit Training in Acute Stroke Rehabilitation Circuit Class Therapy or Seven-Day Week Therapy for Increasing Rehabilitation Intensity of Therapy after Stroke (CIRCIT): A Randomized Controlled Trial Effectiveness of a structured circuit class therapy model in stroke rehabilitation: a protocol for a randomised controlled trial A six-week, resource-efficient mobility program after discharge from rehabilitation improves standing in people affected by stroke: placebo-controlled, randomised trial. Recovery of standing balance and functional mobility after stroke. Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. Clinical application of circuit training for subacute stroke patients: a preliminary study A randomized controlled trial of modified constraint-induced movement therapy for elderly stroke survivors: changes in motor impairment, daily functioning, and quality of life. Randomized Trial of a Robotic Assistive Device for the Upper Extremity During Early Inpatient Stroke Rehabilitation Circuit training in community-living "younger" men after stroke. Efficacy of treatment with a kinaesthetic ability training device on balance and mobility after stroke: a randomized controlled study Additional task-related practice improves mobility and upper limb function early after stroke: a randomised controlled trial. Exercise intervention to prevent falls and enhance mobility in community dwellers after stroke: a protocol for a randomised controlled trial Virtual Reality Exercise Improves Mobility After Stroke: An Inpatient Randomized Controlled Trial
OBJECTIVE To compare the effectiveness of circuit class therapy and individual physiotherapy ( PT ) sessions in improving walking ability and functional balance for people recovering from stroke . DESIGN Nonr and omized , single-blind controlled trial . SETTING Medical rehabilitation ward of a rehabilitation hospital . PARTICIPANTS Sixty-eight persons receiving inpatient rehabilitation after a stroke . INTERVENTIONS Subjects received group circuit class therapy or individual treatment sessions as the sole method of PT service delivery for the duration of their inpatient stay . MAIN OUTCOME MEASURES Five-meter walk test ( 5MWT ) , two-minute walk test ( 2MWT ) , and the Berg Balance Scale ( BBS ) measured 4 weeks after admission . Secondary outcome measures included the Iowa Level of Assistance Scale , Motor Assessment Scale upper-limb items , and patient satisfaction . Measures were taken on admission and 4 weeks later . RESULTS Subjects in both groups showed significant improvements between admission and week 4 in all primary outcome measures . There were no significant between group differences in the primary outcome measures at week 4 ( 5MWT mean difference , .07 m/s ; 2MWT mean difference , 1.8 m ; BBS mean difference , 3.9 points ) . A significantly higher proportion of subjects in the circuit class therapy group were able to walk independently at discharge ( P=.01 ) and were satisfied with the amount of therapy received ( P=.007 ) . CONCLUSIONS Circuit class therapy appeared as effective as individual PT sessions for this sample of subjects receiving inpatient rehabilitation poststroke . Favorable results for circuit classes in terms of increased walking independence and patient satisfaction suggest this model of service delivery warrants further investigation Rationale There is strong evidence for a dose – response relationship between physical therapy early after stroke and recovery of function . The optimal method of maximizing physical therapy within finite health care re sources is unknown . Aims To determine the effectiveness and cost-effectiveness of two alternative models of physical therapy service delivery ( seven-days per week therapy services or group circuit class therapy over five-days a week ) to usual care for people receiving inpatient rehabilitation after stroke . Design Multicenter , three-armed r and omized controlled trial with blinded assessment of outcomes . Study A total of 282 people admitted to inpatient rehabilitation facilities after stroke with an admission functional independence measure ( FIM ) score within the moderate range ( total 40–80 points or motor 38–62 points ) will be r and omized to receive one of three interventions : • usual care therapy over five-days a week • st and ard care therapy over seven-days a week , or • group circuit class therapy over five-days a week . Participants will receive the allocated intervention for the length of their hospital stay . Analysis will be by intention-to-treat . Outcomes The primary outcome measure is walking ability ( six-minute walk test ) at four-week postintervention with three- and six-month follow-up . Economic analysis will include a costing analysis based on length of hospital stay and staffing/re source costs and a cost-utility analysis ( incremental quality of life per incremental cost , relative to usual care ) . Secondary outcomes include walking speed and independence , ability to perform activities of daily living , arm function , quality of life and participant satisfaction Background and Purpose A history of stroke increases risk of falls even years after stroke , and subsequent fear of falling causes individuals to reduce their activities . The purpose of this case series is to describe a group balance skills class for individuals poststroke living in the community , and to assess the feasibility and outcomes of this class . Examination and Intervention Twice a week for 8 weeks , 4 individuals > 6 months poststroke attended a group class design ed to challenge their balance . The group was carried out under the supervision of one physical therapist assisted by physical therapy students . Changes in balance were measured using Berg Balance Scale ( BBS ) , Performance Oriented Mobility Assessment ( POMA ) , and a post-test question naire addressing changes in daily activities . Outcomes Participants ' responses to the question naire and pretest/post-test differences in scores on BBS and POMA suggest trends towards improvement in balance . Relevance A group balance skills class for individuals who had a stroke > 6 months ago appears feasible . Further research is needed to determine the effectiveness of this class for improving functional balance and decreasing incidence of falls Background : Task-specificity , repetition and progression are key variables in the acquisition of motor skill however they have not been consistently implemented in post-stroke rehabilitation . Objective : To evaluate the effectiveness of a stroke rehabilitation plan of care that incorporated task-specific practice , repetition and progression to facilitate functional gain compared to st and ard physical therapy for individuals admitted to an inpatient stroke unit . Methods : Individuals participated in either a circuit training ( CTPT ) model ( n = 72 ) or a st and ard ( SPT ) model ( n = 108 ) of physical therapy , 5 days/week . Each 60 minute circuit training session , delivered according to severity level , consisted of four functional mobility tasks . Daily exercise logs documented both task repetition and progression . Results : The CTPT model was successfully implemented in an acute rehabilitation setting . The CTPT group showed a significantly greater improved change in gait speed from hospital admission to discharge than the SPT group ( 0.21± 0.25 m/sec vs. 0.13± 0.22 m/sec ; p = 0.03 ) . The difference between groups occurred primarily among those who were ambulatory upon admission . There were no significant differences between the two cohorts at 90 days post-stroke as measured by the FONE-FIM , SF-36 and living location . Conclusions : Therapy focused on systematic ally progressed functional tasks can be successfully implemented in an inpatient rehabilitation stroke program . This circuit-training model result ed in greater gains in gait velocity over the course of inpatient rehabilitation compared to the st and ard model of care . Community-based services following hospital discharge to maintain these gains should be included in the continuum of post-stroke care Background Increased therapy has been linked to improvements in functional ability of people with stroke . Aim To determine the effectiveness of two alternative models of increased physiotherapy service delivery ( seven-day week therapy or group circuit class therapy five days a week ) to usual care . Method Three-armed r and omized controlled trial with blinded assessment of outcome . People admitted with a diagnosis of stroke , previously independently ambulant and with a moderate level of disability were recruited .  ‘ Usual care ’ was individual physiotherapy provided five-days a week . Seven-day week therapy was usual care physiotherapy provided seven-days a week . Participants in the circuit class therapy arm of the trial received physiotherapy in group circuit classes in two 90-min sessions , five-days a week . Primary outcome was distance walked on the six-minute walk test at four-weeks post-r and omization . Results Two hundred eighty-three participants were r and omized ; primary outcome data were available for 259 ( 92 % ) . In the seven-day arm participants received an additional three hours of physiotherapy and thosein the circuit class armanadditional 22 h. There were no significant between-group differences at four-weeks in walking distance ( P = 0·72 ) . Length of stay was shorter for seven-day ( mean difference −2·9 days , 95 % confidence interval −17·9 to 12·0 ) and circuit class participants ( mean difference −9·2 days , 95 % confidence interval −24·2 to 5·8 ) compared to usual care , but this was not significant . Conclusions Both seven-day therapy and group circuit class therapy increased physiotherapy time , but walking outcomes were equivalent to usual care Background Currently , the key advocacy in neuroscientific studies for stroke rehabilitation is that therapy should be directed towards task specificity performed with multiple repetitions . Circuit Class Therapy ( CCT ) is well suited to accomplish multiple task-specific activities . However , while repetitive task practice is achievable with circuit class therapy , in stroke survivors repetitive activities may be affected by poor neurologic inputs to motor units , result ing in decreases in discharging rates which consequently may reduce the efficiency of muscular contraction . To accomplish multiple repetitions , stroke survivors may require augmented duration of practice . To date , no study has examined the effect of augmented duration of CCT in stroke rehabilitation , and specifically what duration of CCT is more effective in influencing functional capacity among stroke survivors . Methods / design Using a r and omised controlled trial with blinded outcome assessment , this study is aim ed at determining the effectiveness of structured augmented CCT in stroke rehabilitation . Sixty-eight stroke survivors ( to be recruited from a tertiary health institution in Kano , Northwest , Nigeria ) will be r and omised into one of four groups : three intervention groups of differing CCT duration s namely : 60 min , 90 min , and 120minuntes respectively , and a control group . Participants will take part in an 8-week structured intensive CCT intervention . Participants will be assessed at baseline , post-intervention , and six-month follow-up for the effectiveness of the varied duration s of therapy , using st and ardised tools . Based on the WHO-ICF model , the outcomes are body structure/function , activity limitation , and participation restriction measures . Discussion It is expected that the outcome of this study will clarify whether increasing CCT duration leads to better recovery of motor function in stroke survivors . Trial registration Pan African Clinical Trial Registry ( PACTR ) : Although intervention is effective in reducing the disability associated with stroke , limited re sources mean that physiotherapy services often cease by six months after stroke . The purpose of this clinical trial was to investigate the efficacy of re source -efficient physiotherapy services in improving mobility and quality of life after stroke . Twenty-six people with residual walking difficulties after stroke were r and omised into an experimental or control group after discharge from physiotherapy services . The experimental group participated in a six-week , home-based mobility program . The control group participated in a six-week , home-based program of upper-limb exercises ( i.e. ' sham ' mobility exercises ) . Subjects met with the therapist for prescription of exercises only three times during the six weeks . Strategies used to offset potential problems associated with minimal subject-therapist interaction included videotaped instructions to encourage correct performance of exercises , modification of the environment and involvement of carers to enhance safety , and telephone contact and self-monitoring to promote compliance . St and ing ( Functional Reach ) , walking ( MAS Item 5 ) and quality of life ( SA-SIP30 ) were measured prior to , immediately after , and two months after intervention ceased by an assessor who was blinded to group allocation . Subjects in the experimental group demonstrated significant improvement in st and ing compared to the control group ( p = 0.01 ) which was maintained two months after the cessation of intervention ( p = 0.04 ) . There was no difference between the groups in walking ( p = 0.50 ) or quality of life ( p = 0.70 ) . The six-week , re source -efficient mobility program was effective in improving some of the mobility in people after discharge from stroke rehabilitation . The provision of re source -efficient programs is recommended wherever possible so that people affected by stroke may continue rehabilitation for longer OBJECTIVE To examine the extent to which recovery of functional balance and mobility is accompanied by change in a few specific physiologic measures of postural control . DESIGN Longitudinal prospect i ve study . SETTING Laboratory setting in Ontario . PARTICIPANTS Twenty-seven volunteers ( age , 64.2+/-13.7y ) undergoing 4 weeks of rehabilitation after stroke participated . At initial testing , patients were 32.7+/-18.4 days poststroke and exhibited a moderate level of motor recovery ( lower-extremity and postural control , stages 3 - 4 on the Chedoke-McMaster Stroke Assessment Impairment Inventory ) . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Three functional measures ( Berg Balance Scale , Clinical Outcome Variables Scale , gait speed ) were assessed . Three physiologic measures ( electromyographic data of hamstrings and soleus muscles bilaterally , postural sway , arm acceleration )  were taken while subjects stood quietly on a force platform and while they performed a rapid shoulder flexion movement of the nonparetic upper extremity . RESULTS After 1 month of rehabilitation , there was an overall significant improvement in all outcome measures ( functional , physiologic ) . However , 10 patients failed to show any improvement in the electromyographic activation of hamstrings muscle on the paretic side in response to the rapid arm movement . These patients compensated by increasing the anticipatory activation of the nonparetic hamstrings . CONCLUSION After stroke , patients showed improvement in both physiologic and functional measures of balance and mobility over a 1-month period . We have identified some patients who may be using compensatory strategies to increase function . The factors that may predict those patients who are likely to use compensatory strategies awaits further study OBJECTIVE To evaluate the immediate and retention effects of a 4-week training program on the performance of locomotor-related tasks in chronic stroke . DESIGN R and omized , controlled pilot study with 2-month follow-up . SETTING Rehabilitation center . SUBJECTS A convenience sample consisting of 12 chronic stroke subjects was used . Subjects were r and omly assigned to the experimental or the control group . Three subjects withdrew from the study . INTERVENTION Both experimental and control groups participated in exercise classes three times a week for 4 weeks . The exercise class for the experimental group focused on strengthening the affected lower limb and practicing functional tasks involving the lower limbs , while the control group practice d upper-limb tasks . MAIN OUTCOME MEASURES Lower-limb function was evaluated by measuring walking speed and endurance , peak vertical ground reaction force through the affected foot during sit-to-st and , and the step test . RESULTS The experimental group demonstrated significant immediate and retained ( 2-month follow-up ) improvement ( p < or = .05 ) compared with the control group in walking speed and endurance , force production through the affected leg during sit-to-st and , and the number of repetitions of the step test . CONCLUSION The pilot study provides evidence for the efficacy of a task-related circuit class at improving locomotor function in chronic stroke [ Purpose ] To investigate how task-oriented circuit training for the recovery motor control of the lower-extremity , balance and walking endurance could be clinical ly applied to subacute stroke inpatient group therapy . [ Subjects and Methods ] Twenty subacute stroke patients were r and omly assigned to the intervention group ( n=10 ) or the control group ( n=10 ) . The intervention consisted of a structured , progressive , inpatient circuit training program focused on mobility and gait training as well as physical fitness training that was performed for 90 minutes , 5 days a week for 4 weeks . The control group received individual physiotherapy of neurodevelopmental treatment for 60 minutes , 5 days a week for 4 weeks . Outcome measures were lower-extremity motor control , balance , gait endurance and activities of daily living before and after 4 weeks . [ Results ] There were no significant differences at baseline between the two groups . After 4 weeks , both groups showed significant improvements in all outcome measures , but there were no significant differences between the two groups during the invention period . [ Conclusion ] In spite of the small sample size , these findings suggest that task-oriented circuit training might be used as a cost-effective and alternative method of individual physiotherapy for the motor recovery of lower-extremity , balance and walking endurance of subacute stroke patients OBJECTIVE To examine the benefits of modified constraint-induced movement therapy ( mCIMT ) on motor function , daily function , and health-related quality of life ( HRQOL ) in elderly stroke survivors . DESIGN Two-group r and omized controlled trial , with pretreatment and posttreatment measures . SETTING Rehabilitation clinics . PARTICIPANTS Twenty-six elderly stroke patients ( mean age , 72 y ) with 0.5 to 31 months postonset of a first-ever cerebrovascular accident . INTERVENTIONS Twenty-six patients received either mCIMT ( restraint of the unaffected limb combined with intensive training of the affected limb ) or traditional rehabilitation for a period of 3 weeks . MAIN OUTCOME MEASURES Outcome measures included the Fugl-Meyer Assessment ( FMA ) , FIM instrument , Motor Activity Log ( MAL ) , and Stroke Impact Scale ( SIS ) . The FMA evaluated the severity of motor impairment ; the FIM instrument and MAL reported daily function ; and the SIS detected HRQOL . RESULTS The mCIMT group exhibited significantly greater improvements in motor function , daily function , and the physical domain of HRQOL than the traditional rehabilitation group . Patients in the mCIMT group perceived significantly greater percent of recovery after treatment than patients in the traditional rehabilitation group . CONCLUSIONS These findings suggest mCIMT is a promising intervention for improving motor function , daily function , and physical aspects of HRQOL in elderly patients with stroke . The mCIMT was well tolerated by the elderly patients even though it is a rigorous training program Background . A recent Cochrane Review showed that early robotic training of the upper limb in stroke survivors can be more effective than other interventions when improving activities of daily living involving the arm function is the aim of therapy . Objective . We tested for efficacy of the study a protocol which involved the use of the NeReBot therapy in partial substitution of st and ard upper limb rehabilitation in post – acute stroke patients . Methods . In this dose-matched , r and omized controlled clinical trial , 34 hemiparetic participants with movement against gravity in shoulder , elbow , and wrist muscle groups were enrolled within 15 days of the onset of stroke . All participants received a total daily rehabilitation treatment for 120 minutes , 5 days per week for 5 weeks . The control group received st and ard therapy for the upper limb . The experimental group received st and ard therapy ( 65 % of exercise time ) associated with robotic training ( 35 % of exercise time ) . Muscle tone ( Modified Ashworth Scale ) , strength ( Medical Research Council ) , and synergism ( Fugl-Meyer motor scores ) were measured at impairment level , whereas dexterity ( Box and Block Test and Frenchay Arm Test ) and activities of daily living ( Functional Independence Measure ) were measured at activity level . All assessment s were performed at baseline , at the end of therapy ( time T1 ) , at 3 months ( time T2 ) , and at 7 months ( time T3 ) after entry . All between-group analyses were tested using nonparametric test with Bonferroni ’s adjustments for multiple testing . Results . No significant between-group differences were found with respect to demographic characteristics , motor , dexterity , and ADLs at baseline , postintervention ( T1 ) and at follow-up ( T2 and T3 ) . Conclusions . The robot therapy by NeReBot did not lead to better outcomes compared with conventional inpatient rehabilitation OBJECTIVES We sought to assess a training program focused on muscle strength and endurance in persons with prior stroke . METHODS Thirty men with a slight hemiparesis caused by a first occurrence of stroke at least 6 months earlier were included with an average age of 54 years . The following was assessed before and after an 8-week period : muscle strength , endurance , work capacity , and activity level . The training group consisted of 21 persons and 9 served as control subjects . There were no differences between the groups in the various assessment s from the start . The training was set up as circuit training with 5 stations aim ing to strengthen the muscles and increase endurance in the bilateral lower limbs . The session lasted for 45 minutes , 3 times per week , for 8 weeks . On eligible persons in the training group , double-sided muscle biopsies were also performed before and after . RESULTS There was significance in improved muscle strength and improved peak oxygen uptake for the paretic leg , which was reflected in the muscle enzymes . The nonparetic side also showed improvement , but to a lesser extent . The control group remained unchanged . CONCLUSIONS Stroke survivors can improve muscle strength , endurance , and work capacity in both the paretic and nonparetic leg with a circuit training program Objective : To investigate whether the addition of a kinaesthetic ability training device could enhance the effect of a conventional rehabilitation programme on balance and mobility in hemiparetic patients late after stroke . Design : R and omized , controlled , assessor-blinded trial . Setting : The rehabilitation ward of a university hospital . Thirty hemiparetic patients ( mean age ( SD ) of 57.4 ( 8.1 ) years ) late after stroke ( mean time since stroke ( SD ) 545.2 ( 99.9 ) days ) were assigned r and omly to an experimental or a control group . Interventions : The control group ( n = 15 ) participated in a conventional rehabilitation programme . The experimental group ( n = 15 ) participated in balance training with a kinaesthetic ability training device in addition to a conventional rehabilitation programme for four weeks , five days a week . Outcome measures : Kinaesthetic ability training static and dynamic balance indices , balance and lower extremity subscores of the Fugl-Meyer Stroke Assessment Instrument ( FMA ) , total motor and locomotor subitem scores of the Functional Independence Measure ( FIM ) were evaluated at baseline and after treatment . Results : The experimental group had greater improvement in measures of balance including static ( P = 0.045 ) and dynamic balance index ( P = 0.001 ) and FMA balance score ( P = 0.001 ) than the control group . No between-group differences were detected in subscore of FMA , total motor and locomotor subscores of FIM . There were significant improvements in balance subscores of FMA , static and dynamic balance indexes in the experimental group and in sub-item scores of FIM and lower extremity scores of FMA in both groups . Conclusion : Kinaesthetic ability training in addition to a conventional rehabilitation programme is effective in improving balance late after stroke . However , this improvement is not reflected in individual functional status The purpose of this study was to investigate whether additional practice of either upper limb or mobility tasks improved functional outcome during inpatient stroke rehabilitation . This prospect i ve , r and omised , single blind clinical trial recruited 30 stroke subjects into either an Upper Limb or a Mobility Group . All subjects received their usual rehabilitation and an additional session of task-related practice using a circuit class format . Independent assessors , blinded to group allocation , tested all subjects . Outcome measures used were three items of the Jebsen Taylor H and Function Test ( JTHFT ) , two  arm items  of the Motor Assessment Scale ( MAS ) , and three mobility measures , the Timed Up and Go Test ( TUGT ) , Step Test , and Six Minute Walk Test ( 6MWT ) . Both groups improved significantly between pre- and post-tests on all of the mobility measures , however only the Upper Limb Group made a significant improvement on the JTHFT and MAS upper arm items . Following four weeks training , the Mobility Group had better locomotor ability than the Upper Limb Group ( between-group differences in the 6MWT of 116.4 m , 95 % CI 31.4 to 201.3 m , Step Test 2.6 repetitions , 95 % CI -1.0 to 6.2 repetitions , and TUGT -7.6 sec , 95 % CI -15.5 to 0.2 sec ) . The JTHFT dexterity scores in the Upper Limb Group were 6.5 sec ( 95 % CI -7.4 to 20.4 sec ) faster than the Mobility Group . Our findings support the use of additional task-related practice during inpatient stroke rehabilitation . The circuit class format was a practical and effective means to provide supervised additional practice that led to significant and meaningful functional gains Background Stroke is the most common disabling neurological condition in adults . Falls and poor mobility are major contributors to stroke-related disability . Falls are more frequent and more likely to result in injury among stroke survivors than among the general older population . Currently there is good evidence that exercise can enhance mobility after stroke , yet ongoing exercise programs for general community-based stroke survivors are not routinely available . This r and omised controlled trial will investigate whether exercise can reduce fall rates and increase mobility and physical activity levels in stroke survivors . Methods and design Three hundred and fifty community dwelling stroke survivors will be recruited . Participants will have no medical contradictions to exercise and be cognitively and physically able to complete the assessment s and exercise program .  After the completion of the pre-test assessment , participants will be r and omly allocated to one of two intervention groups . Both intervention groups will participate in weekly group-based exercises and a home program for twelve months . In the lower limb intervention group , individualised programs of weight-bearing balance and strengthening exercises will be prescribed . The upper limb/cognition group will receive exercises aim ed at management and improvement of function of the affected upper limb and cognition carried out in the seated position . The primary outcome measures will be falls ( measured with 12 month calendars ) and mobility . Secondary outcome measures will be risk of falling , physical activity levels , community participation , quality of life , health service utilisation , upper limb function and cognition . Discussion This study aims to establish and evaluate community-based sustainable exercise programs for stroke survivors . We will determine the effects of the exercise programs in preventing falls and enhancing mobility among people following stroke . This program , if found to be effective , has the potential to be implemented within existing community services . Trial registration The protocol for this study is registered with the Australian New Zeal and Clinical Trials Registry ( ACTRN12606000479505 ) Background and Purpose — Exercise using virtual reality ( VR ) has improved balance in adults with traumatic brain injury and community-dwelling older adults . Rigorous r and omized studies regarding its efficacy , safety , and applicability with individuals after stroke are lacking . The purpose of this study was to determine whether an adjunct VR therapy improves balance , mobility , and gait in stroke rehabilitation in patients . Methods — A blinded r and omized controlled trial study ing 59 stroke survivors on an inpatient stroke rehabilitation unit was performed . The treatment group ( n=30 ) received st and ard stroke rehabilitation therapy plus a program of VR exercises that challenged balance ( eg , soccer goal tending , snowboarding ) performed while st and ing . The control group ( n=29 ) received st and ard stroke rehabilitation therapy plus exposure to identical VR environments but whose games did not challenge balance ( performed in sitting ) . VR training consisted of 10 to 12 thirty-minute daily sessions for a 3-week period . Objective outcome measures of balance and mobility were assessed before , immediately after , and 1 month after training . Results — Confidence intervals and effect sizes favored the treatment group on the Timed Up and Go and the Two-Minute Walk Test , with both groups meeting minimal clinical important differences after training . More individuals in the treatment group than in the control group showed reduced impairment in the lower extremity as measured by the Chedoke McMaster Leg domain ( P=0.04 ) immediately after training . Conclusions — This VR exercise intervention for inpatient stroke rehabilitation improved mobility-related outcomes . Future studies could include nonambulatory participants as well as the implementation strategies for the clinical use of VR . Clinical Trial Registration — URL : http://www.ANZCTR.org.au/. Unique identifier : ACTRN12613000710729
Circuit class therapy is safe and effective in improving mobility in people after stroke and , when provided as part of hospital-based rehabilitation , may reduce length of stay
OBJECTIVE To examine the effectiveness of group circuit class therapy for improving the mobility of adults after stroke .