Coralie English1,2, Julie Bernhardt2, Maria Crotty3, Adrian Esterman4, Leonie Segal5, Susan Hillier1. 1. International Centre for Allied Health Evidence, Sansom Institute of Health Research, University of South Australia, Adelaide, SA, Australia. 2. Stroke Division, Florey Institute of Neuroscience and Mental Health, Austin Campus, Heidelberg, Vic., Australia. 3. Department of Rehabilitation and Aged Care, Flinders University, Bedford Park, SA, Australia. 4. Division of Health Sciences, University of South Australia, Adelaide, SA, Australia. 5. Health Economics and Social Policy Group, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia.
Abstract
BACKGROUND: Increased therapy has been linked to improvements in functional ability of people with stroke. AIM: To determine the effectiveness of two alternative models of increased physiotherapy service delivery (seven-day week therapy or group circuit class therapy five days a week) to usual care. METHOD: Three-armed randomized controlled trial with blinded assessment of outcome. People admitted with a diagnosis of stroke, previously independently ambulant and with a moderate level of disability were recruited. 'Usual care' was individual physiotherapy provided five-days a week. Seven-day week therapy was usual care physiotherapy provided seven-days a week. Participants in the circuit class therapy arm of the trial received physiotherapy in group circuit classes in two 90-min sessions, five-days a week. Primary outcome was distance walked on the six-minute walk test at four-weeks post-randomization. RESULTS:Two hundred eighty-three participants were randomized; primary outcome data were available for 259 (92%). In the seven-day arm participants received an additional three hours of physiotherapy and those in the circuit class arm an additional 22 h. There were no significant between-group differences at four-weeks in walking distance (P = 0.72). Length of stay was shorter for seven-day (mean difference -2.9 days, 95% confidence interval -17.9 to 12.0) and circuit class participants (mean difference -9.2 days, 95% confidence interval -24.2 to 5.8) compared to usual care, but this was not significant. CONCLUSIONS: Both seven-day therapy and group circuit class therapy increased physiotherapy time, but walking outcomes were equivalent to usual care.
RCT Entities:
BACKGROUND: Increased therapy has been linked to improvements in functional ability of people with stroke. AIM: To determine the effectiveness of two alternative models of increased physiotherapy service delivery (seven-day week therapy or group circuit class therapy five days a week) to usual care. METHOD: Three-armed randomized controlled trial with blinded assessment of outcome. People admitted with a diagnosis of stroke, previously independently ambulant and with a moderate level of disability were recruited. 'Usual care' was individual physiotherapy provided five-days a week. Seven-day week therapy was usual care physiotherapy provided seven-days a week. Participants in the circuit class therapy arm of the trial received physiotherapy in group circuit classes in two 90-min sessions, five-days a week. Primary outcome was distance walked on the six-minute walk test at four-weeks post-randomization. RESULTS: Two hundred eighty-three participants were randomized; primary outcome data were available for 259 (92%). In the seven-day arm participants received an additional three hours of physiotherapy and those in the circuit class arm an additional 22 h. There were no significant between-group differences at four-weeks in walking distance (P = 0.72). Length of stay was shorter for seven-day (mean difference -2.9 days, 95% confidence interval -17.9 to 12.0) and circuit class participants (mean difference -9.2 days, 95% confidence interval -24.2 to 5.8) compared to usual care, but this was not significant. CONCLUSIONS: Both seven-day therapy and group circuit class therapy increased physiotherapy time, but walking outcomes were equivalent to usual care.
Authors: David H Saunders; Mark Sanderson; Sara Hayes; Maeve Kilrane; Carolyn A Greig; Miriam Brazzelli; Gillian E Mead Journal: Cochrane Database Syst Rev Date: 2016-03-24
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Authors: Matthew W McDonald; Kathryn S Hayward; Ingrid C M Rosbergen; Matthew S Jeffers; Dale Corbett Journal: Front Behav Neurosci Date: 2018-07-11 Impact factor: 3.558