title: Circuit class therapy and 7-day-week therapy increase physiotherapy time, but not patient activity: early results from the CIRCIT trial.
abstract: OBJECTIVE
  The optimum model of physiotherapy service delivery for maximizing active task practice during rehabilitation after stroke is unknown. The purpose of the study was to examine the relative effectiveness of 2 alternative models of physiotherapy service delivery against a usual care control with regard to increasing patient activity.
  
  
  METHODS
  Substudy within a large 3-armed randomized controlled trial, which compared 3 different models of physiotherapy service delivery, was provided for 4 weeks during subacute, inpatient rehabilitation (n=283). The duration of all physiotherapy sessions was recorded. In addition, 32 participants were observed at 10-minute intervals for 1 weekday and 1 weekend day between 8:00 am and 4:30 pm. At each observation, we recorded physical activity, location, and people present.
  
  
  RESULTS
  Participants receiving 7-day-week and circuit class therapy received an additional 3 hours and 22 hours of physiotherapy time, respectively, when compared with usual care. Participants were standing or walking for a median of 8.2% of observations. On weekdays, circuit class therapy participants spent more time in therapy-related activity (10.2% of observations) when compared with usual care participants (6.1% of observations). On weekends, 7-day therapy participants spent more time in therapy-related activity (4.2% of observations) when compared with both usual care and circuit class therapy participants (0% of observations for both groups). Activity levels outside of therapy sessions did not differ between groups.
  
  
  CONCLUSIONS
  A greater dosage of physiotherapy time did not translate into meaningful increases in physical activity across the day.
  
  
  BACKGROUND
  http://www.anzctr.org.au/. Unique identifier: ACTRN12610000096055.
authors.affiliation: From the International Centre for Allied Health Evidence, University of South Australia, Adelaide, Australia (C.E., S.H.); and Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia (C.E., J.B.). Coralie.english@unisa.edu.au.
authors.forename: Coralie
authors.initials: C
authors.lastname: English
authors.affiliation: From the International Centre for Allied Health Evidence, University of South Australia, Adelaide, Australia (C.E., S.H.); and Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia (C.E., J.B.).
authors.forename: Julie
authors.initials: J
authors.lastname: Bernhardt
authors.affiliation: From the International Centre for Allied Health Evidence, University of South Australia, Adelaide, Australia (C.E., S.H.); and Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia (C.E., J.B.).
authors.forename: Susan
authors.initials: S
authors.lastname: Hillier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D009043:Motor Activity; D026741:Physical Therapy Modalities; D000071939:Stroke Rehabilitation; D016032:Randomized Controlled Trials as Topic
keywords: physiotherapy (techniques); rehabilitation