According to a report from the British Medical Journal (2012; 344; doi: http://dx.doi.org/10.1136/bmj/e2672), 25%–74% of the world’s 50 million stroke survivors require assistance or are fully dependent on caregivers. To gain more physical independence, many seek help from physical therapists. That same report suggests circuit training can be a successful alternative to physical therapy.
“We investigated the safety and effects of task-oriented circuit training as an alternative to usual physiotherapy provided during outpatient treatment at a rehabilitation center to improve walking,” the authors said.
To learn this, the researchers studied 250 stroke patients from nine rehabilitation centers in the Netherlands. Subjects were required to be able to walk for at least 10 minutes without assistance and were randomly assigned to circuit training or a “usual physiotherapy” protocol. Those in the circuit training group participated in two 90-minute sessions per week for 12 weeks. Each session included a 5-minute warm-up, a 60-minute circuit consisting of eight stations, a 10-minute break/evaluation and a 15-minute group game. Throughout the circuit, participants worked in pairs; one would perform a task for 3 minutes while the other observed. Once the 3 minutes was up, they switched roles. Pairs then had 1 minute to move to the next station.
The physical therapy group’s sessions were designed to “improve control of standing balance, physical condition, and walking competency,” according to Dutch guidelines.
The researchers determined that circuit training could be a safe and effective means for helping stroke patients with mild to moderate disability improve physical competency. However, they also learned that circuit training was inferior to physical therapy for improving self-reported mobility.
“In contrast to patients’ self-reported mobility, the circuit training proved more effective in terms of walking speed, stair walking, and walking distance, though differences were small,” the authors added. “Another important aspect of the task-oriented circuit training is that it is offered in groups ranging from two to eight patients, suggesting that it is a cost-effective treatment after stroke by lowering ratios of staff to patients.”