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The Combined Use of Transcranial Direct Current Stimulation and Robotic Therapy for the Upper Limb
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Circuit class therapy for improving mobility after stroke.

Coralie English1, Susan L Hillier, Elizabeth A Lynch

  • 1School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, University Dr, Callaghan, NSW, Australia, 2308.

The Cochrane Database of Systematic Reviews
|June 3, 2017
PubMed
Summary
This summary is machine-generated.

Circuit class therapy (CCT) significantly improves mobility in stroke survivors, enhancing walking distance, speed, and balance confidence. While generally safe, monitoring for falls during CCT is recommended.

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Area of Science:

  • Neurorehabilitation
  • Clinical Trials
  • Stroke Recovery

Background:

  • Circuit class therapy (CCT) provides a supervised group setting for post-stroke patients to increase task practice without additional staff.
  • This review is an update of the 2010 publication.

Purpose of the Study:

  • To evaluate the effectiveness and safety of CCT in improving mobility for adult stroke survivors.
  • To synthesize evidence from randomized controlled trials on CCT's impact on post-stroke mobility.

Main Methods:

  • A comprehensive search of multiple electronic databases and trial registers was conducted up to January 2017.
  • Included were 17 randomized controlled trials (RCTs) involving 1297 participants diagnosed with stroke.
  • Data on mobility, balance, and safety outcomes were independently extracted and analyzed by review authors.

Main Results:

  • CCT significantly improved walking capacity (Six-Minute Walk Test) and gait speed compared to control interventions.
  • Participants in CCT showed enhanced performance in Timed Up and Go tests and reported greater balance confidence (Activities of Balance Confidence scale).
  • Improvements were also noted in independent mobility measures, with a non-significant trend towards shorter hospital stays; a non-significant increased risk of falls during therapy was observed.

Conclusions:

  • Moderate evidence supports CCT's effectiveness in improving post-stroke mobility, including walking and balance.
  • CCT may lead to clinically meaningful improvements in mobility and independence, with potential for greater effects later after stroke.
  • Further high-quality research is needed to explore quality of life, cost-benefits, and optimal CCT implementation, alongside continued monitoring of fall risk.