title: Is more physiotherapy better after stroke?
abstract: 'More is better' has been the mantra for physiotherapists working in stroke rehabilitation. Studies examining the neuroplasticity of the brain have shown that repetitive, meaningful practice is essential to drive positive plasticity, and meta-analyses of clinical trials provide evidence of benefit of increased therapy provision. However, a recent large clinical trial appears to contradict this evidence. The CIRCIT trial investigated two alternative models of physiotherapy service delivery for people after stroke. Despite participants in the circuit class therapy arm of the trial receiving an additional 22 h of physiotherapy time, their outcomes were not superior to usual care. This editorial interrogates and provides some possible explanations for these apparently contradictory findings.
authors.affiliation: International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia.|Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.
authors.forename: Coralie
authors.initials: C
authors.lastname: English
authors.affiliation: Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Janne
authors.initials: J
authors.lastname: Veerbeek
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D000071939:Stroke Rehabilitation
keywords: cerebral hemorrhage; cerebral infarction; physiotherapy; rehabilitation; stroke; therapy