title: Circuit class or seven-day therapy for increasing intensity of rehabilitation after stroke: protocol of the CIRCIT trial.
abstract: BACKGROUND
  There is strong evidence for a dose-response relationship between physical therapy early after stroke and recovery of function. The optimal method of maximizing physical therapy within finite health care resources is unknown.
  
  
  OBJECTIVE
  To determine the effectiveness and cost-effectiveness of two alternative models of physical therapy service delivery (seven-days per week therapy services or group circuit class therapy over five-days a week) to usual care for people receiving inpatient rehabilitation after stroke.
  
  
  METHODS
  Multicenter, three-armed randomized controlled trial with blinded assessment of outcomes.
  
  
  METHODS
  A total of 282 people admitted to inpatient rehabilitation facilities after stroke with an admission functional independence measure (FIM) score within the moderate range (total 40-80 points or motor 38-62 points) will be randomized to receive one of three interventions: • usual care therapy over five-days a week • standard care therapy over seven-days a week, or • group circuit class therapy over five-days a week. Participants will receive the allocated intervention for the length of their hospital stay. Analysis will be by intention-to-treat.
  
  
  RESULTS
  The primary outcome measure is walking ability (six-minute walk test) at four-week postintervention with three- and six-month follow-up. Economic analysis will include a costing analysis based on length of hospital stay and staffing/resource costs and a cost-utility analysis (incremental quality of life per incremental cost, relative to usual care). Secondary outcomes include walking speed and independence, ability to perform activities of daily living, arm function, quality of life and participant satisfaction.
authors: International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, SA, Australia. susan.hillier@unisa.edu.au
authors: Susan
authors: S
authors: Hillier
authors: Coralie
authors: C
authors: English
authors: Maria
authors: M
authors: Crotty
authors: Leonie
authors: L
authors: Segal
authors: Julie
authors: J
authors: Bernhardt
authors: Adrian
authors: A
authors: Esterman
mesh_terms: D000203:Activities of Daily Living; D001132:Arm / Q000502:physiology; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D006801:Humans; D057187:Independent Living; D007902:Length of Stay; D009483:Neuropsychological Tests; D017060:Patient Satisfaction; D018579:Patient Selection; D026741:Physical Therapy Modalities / Q000191:economics / Q000458:organization & administration*; D011788:Quality of Life; D020127:Recovery of Function; D018401:Sample Size; D020521:Stroke / Q000191:economics / Q000628:therapy*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology