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Cochrane Database of Systematic Reviews

Circuit class therapy for improving mobility after stroke

Overview of attention for article published in this source, July 2010
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Title
Circuit class therapy for improving mobility after stroke
Published by
John Wiley & Sons, Ltd, July 2010
DOI 10.1002/14651858.cd007513.pub2
Pubmed ID
Authors

English, Coralie, Hillier, Susan L

Abstract

Circuit class therapy (CCT) offers a supervised group forum for people after stroke to practise tasks, enabling increased practise time without increasing staffing. To examine the effectiveness and safety of CCT on mobility in adults with stroke. We searched the Cochrane Stroke Group Trials Register (last searched October 2009), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 2, 2009), MEDLINE (1950 to November 2008), EMBASE (1980 to November 2008), CINAHL (1982 to November 2008) and 14 other electronic databases (to November 2008). We also searched proceedings from relevant conferences, reference lists and unpublished theses; contacted authors of published trials and other experts in the field; and searched relevant clinical trials and research registers. Randomised or quasi-randomised controlled trials including people over 18 years old diagnosed with stroke of any severity, at any stage, or in any setting, receiving CCT. Two review authors independently selected trials for inclusion, assessed methodological quality and extracted data. We included six trials involving 292 participants. Participants were long-term stroke survivors living in the community or receiving inpatient rehabilitation. All could walk 10 metres with or without assistance. Four studies measured walking capacity and three measured gait speed, demonstrating that CCT was superior to the comparison intervention (Six Minute Walk Test: mean difference (MD), fixed 76.57 metres, 95% confidence interval (CI) 38.44 to 114.70, P < 0.0001; gait speed: MD, fixed 0.12 m/s, 95% CI 0.00 to 0.24, P = 004). Two studies measured balance, showing a superior effect in favour of CCT (Step Test: MD, fixed 3.00 steps, 95% CI 0.08 to 5.91, P = 0.04; activities-specific balance and confidence: MD, fixed 7.76, 95% CI 0.66 to 14.87, P = 0.03). Studies also measured other balance items showing no difference in effect. Length of stay (two studies) showed a significant effect in favour of CCT (MD, fixed -19.73 days, 95% CI -35.43 to -4.04, P = 0.01). Only two studies measured adverse events (falls during therapy): all were minor. CCT is safe and effective in improving mobility for people after moderate stroke and may reduce inpatient length of stay. Further research is required, investigating quality of life, participation and cost-benefits, that compares CCT to standard care and that also investigates the differential effects of stroke severity, latency and age.

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Mendeley readers

The data shown below were compiled from readership statistics for 107 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
France 1 <1%
Canada 1 <1%
Unknown 105 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 22 21%
Student > Ph. D. Student 15 14%
Researcher 14 13%
Student > Bachelor 12 11%
Student > Doctoral Student 8 7%
Other 18 17%
Unknown 18 17%
Readers by discipline Count As %
Medicine and Dentistry 33 31%
Nursing and Health Professions 15 14%
Agricultural and Biological Sciences 7 7%
Neuroscience 5 5%
Psychology 5 5%
Other 18 17%
Unknown 24 22%