People with stroke spend more time in active task practice, but similar time in walking practice, when physiotherapy rehabilitation is provided in circuit classes compared to individual therapy sessions: an observational study

Question: Do people with stroke spend more time in active task practice during circuit class therapy sessions versus individual physiotherapy sessions? Do people with stroke practise different tasks during circuit class therapy sessions versus individual physiotherapy sessions? Design: Prospective, observational study. Participants: Twenty-nine people with stroke in inpatient rehabilitation settings. Interventions: Individual therapy sessions and circuit class therapy sessions provided within a larger randomised controlled trial. Outcome measures: Seventy-nine therapy sessions were video-recorded and the footage was analysed for time spent engaged in various categories of activity. In a subsample of 28 videos, the number of steps taken by people with stroke per therapy session was counted. Results: Circuit class therapy sessions were of a longer duration (mean difference 38.0 minutes, 95% CI 29.9 to 46.1), and participants spent more time engaged in active task practice (mean difference 23.8 minutes, 95% CI 16.1 to 31.4) compared with individual sessions. A greater percentage of time in circuit class therapy sessions was spent practising tasks in sitting (mean difference 5.3%, 95% CI 2.4 to 8.2) and in sit-to-stand practice (mean difference 2.7%, 95% CI 1.4 to 4.1), and a lower percentage of time in walking practice (mean difference 19.1%, 95% CI 10.0 to 28.1) compared with individual sessions. Participants took an average of 371 steps (SD 418) during therapy sessions and this did not differ significantly between group and individual sessions. Conclusion: People with stroke spent more time in active task practice, but a similar amount of time in walking practice when physiotherapy was offered in circuit class therapy sessions versus individual therapy sessions. There is a need for effective strategies to increase the amount of walking practice during physiotherapy sessions for people after stroke. (C) 2014 Australian Physiotherapy Association. Published by Elsevier B.V.