Nonsignificant summary effect sizes in favor of task-oriented circuit class training were found for the step test and balance control .
This meta- analysis supports the use of task-oriented circuit class training to improve gait and gait-related activities in patients with chronic stroke .
BACKGROUND AND PURPOSE There is increasing interest in the potential benefits of circuit class training after stroke , but its effectiveness is uncertain .
Our aim was to systematic ally review r and omized , controlled trials of task-oriented circuit class training on gait and gait-related activities in patients with stroke .
Improvements in Speed-Based Gait Classifications Are Meaningful
Background and Purpose — Gait velocity is a powerful indicator of function and prognosis after stroke . Gait velocity can be stratified into clinical ly meaningful functional ambulation classes , such as household ambulation ( < 0.4 m/s ) , limited community ambulation ( 0.4 to 0.8 m/s ) , and full community ambulation ( > 0.8 m/s ) . The purpose of the current study was to determine whether changes in velocity-based community ambulation classification were related to clinical ly meaningful changes in stroke-related function and quality of life . Methods — In subacute stroke survivors with mild to moderate deficits who participated in a r and omized clinical trial of stroke rehabilitation and had a baseline gait velocity of 0.8 m/s or less , we assessed the effect of success versus failure to achieve a transition to the next class on function and quality of life according to domains of the Stroke Impact Scale ( SIS ) . Results — Of 64 eligible participants , 19 were initially household ambulators , and 12 of them ( 68 % ) transitioned to limited community ambulation , whereas of 45 initially limited community ambulators , 17 ( 38 % ) became full community ambulators . Function and quality -of-life SIS scores after treatment were significantly higher among survivors who achieved a favorable transition compared with those who did not . Among household ambulators , those who transitioned to limited or full community ambulation had significantly better SIS scores in mobility ( P=0.0299 ) and participation ( P=0.0277 ) . Among limited community ambulators , those who achieved the transition to full community ambulatory status had significantly better scores in SIS participation ( P=0.0085 ) . Conclusions — A gait velocity gain that results in a transition to a higher class of ambulation results in better function and quality of life , especially for household ambulators . Household ambulators possibly had more severe stroke deficits , reducing the risk of “ ceiling ” effects in SIS-measured activities of daily living and instrumental activities of daily living . Outcome assessment based on transitions within a mobility classification scheme that is rooted in gait velocity yields potentially meaningful indicators of clinical benefit . Outcomes should be selected that are clinical ly meaningful for all levels of severity
Nonsignificant summary effect sizes in favor of task-oriented circuit class training were found for the step test and balance control .
This meta- analysis supports the use of task-oriented circuit class training to improve gait and gait-related activities in patients with chronic stroke .
BACKGROUND AND PURPOSE There is increasing interest in the potential benefits of circuit class training after stroke , but its effectiveness is uncertain .
Our aim was to systematic ally review r and omized , controlled trials of task-oriented circuit class training on gait and gait-related activities in patients with stroke .