title: Circuit class therapy or seven-day week therapy for increasing rehabilitation intensity of therapy after stroke (CIRCIT): a randomized controlled trial.
abstract: BACKGROUND
  Increased therapy has been linked to improvements in functional ability of people with stroke.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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: International Centre for Allied Health Evidence, Sansom Institute of Health Research, University of South Australia, Adelaide, SA, Australia.|Stroke Division, Florey Institute of Neuroscience and Mental Health, Austin Campus, Heidelberg, Vic., Australia.
authors: Coralie
authors: C
authors: English
authors: Stroke Division, Florey Institute of Neuroscience and Mental Health, Austin Campus, Heidelberg, Vic., Australia.
authors: Julie
authors: J
authors: Bernhardt
authors: Department of Rehabilitation and Aged Care, Flinders University, Bedford Park, SA, Australia.
authors: Maria
authors: M
authors: Crotty
authors: Division of Health Sciences, University of South Australia, Adelaide, SA, Australia.
authors: Adrian
authors: A
authors: Esterman
authors: Health Economics and Social Policy Group, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia.
authors: Leonie
authors: L
authors: Segal
authors: International Centre for Allied Health Evidence, Sansom Institute of Health Research, University of South Australia, Adelaide, SA, Australia.
authors: Susan
authors: S
authors: Hillier
mesh_terms: D000368:Aged; D001315:Australia; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D026741:Physical Therapy Modalities; D012047:Rehabilitation Centers; D012720:Severity of Illness Index; D016037:Single-Blind Method; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking
keywords: circuit class therapy; physiotherapy; rehabilitation; stroke recovery; task practice; weekend therapy