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THERAPY-Magazin
Effects of device-based circuit training in stroke patients

Explore how group-based, device-supported circuit training using gait, balance and movement trainers may improve walking ability, speed and mobility in stroke rehabilitation patients.

Author
Jakob Tiebel
Business Owner, N+ Digital Health Agency
Due to growing economic and demographic pressures, focus is shifting increasingly onto group therapies. There is already moderate evidence of the effectiveness and superiority of circuit training after stroke. A pilot study is now being conducted to investigate the use of a device-based setting to improve walking ability.
The consequences of a stroke often manifest themselves as significant limitations in walking ability and participation, so that regaining the ability to walk is extremely important for many patients as part of neurological rehabilitation. A combination of conventional and electromechanical end-effector-based gait training is recommended for treatment [3]. Assisted gait training was also shown to have an effect on the parameters of walking distance and walking speed [2]. Due to growing economic and demographic pressures, focus is shifting onto group therapies. There is already moderate evidence of the effectiveness and superiority of group-based circuit training in relation to the walking parameters [1].

Therefore the aim of the planned study, according to the authors, is to investigate the effects of device-based circuit training in a group setting on the walking parameters of subacute stroke patients unable to walk.

For the prospective pilot study, scientists from Bad Salzuflen and Gera, in Germany, planned to recruit 40 subacute stroke patients unable to walk for a three-week device-based circuit training course between October 2019 and March 2020. Three patients each undergo one-hour training three times a week on an end-effector-based gait trainer, a balance trainer and a movement exerciser. As a primary target parameter, walking ability is evaluated using Functional Ambulation Categories (FAC). As secondary parameters, the walking distance in metres, the walking speed, using the 5-metre walking test (5mWT), and the muscle strength of the lower extremities, using the Motricity Index - Leg (MI-L), are recorded. Data is collected before the intervention and three weeks after. Non-parametric test procedures are used to calculate systematic group differences.

No results were known at the time of printing. It is expected that after the intervention phase an improvement of the primary target parameter of walking ability as well as the secondary gait parameters will be observed. If the results are positive, the design of this study means that future studies will have to investigate whether device-based circuit training is superior to standard therapy.

The original version of the abstract for this scientific paper was submitted to the annual conference of the German Society for Neurological Rehabilitation (DGNR) in 2019 and was published in the conference proceedings [4].
Ambulante Rehabilitation
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Standing & Balancing
Stationäre Rehabilitation
THERAPY 2020-II
THERAPY Magazine
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Author
Jakob Tiebel
Business Owner, N+ Digital Health Agency
Jakob Tiebel studied applied psychology with a focus on health economics. He has clinical expertise from his previous therapeutic work in neurorehabilitation. He conducts research and publishes on the theory-practice transfer in neurorehabilitation and is the owner of Native.Health, an agency for digital health marketing.
References:
  1. English C, Hillier SL (2010). Circuit class therapy for improving mobility after stroke. Cochrane Database Syst Rev. 2010 Jul 7;(7):CD007513. doi: 10.1002/14651858.CD007513.pub2. Review. Update in: Cochrane Database Syst Rev. 2017 Jun 02;6:CD007513. PubMed PMID: 20614460; PubMed Central PMCID: PMC6464862.
  2. Mehrholz J, Pohl M, Kugler J, Elsner B (2018). The Improvement of Walking Ability Following Stroke. Dtsch Arztebl Int. 2018 Sep 28;115(39):639-645. doi: 10.3238/arztebl.2018.0639. PubMed PMID: 30375325; PubMed Central PMCID: PMC6224539.
  3. Mehrholz J, Thomas S, Werner C, Kugler J, Pohl M, Elsner B (2017). Electromechanical-assisted training for walking after stroke. Cochrane Database Syst Rev. 2017 May 10;5:CD006185. doi: 10.1002/14651858.CD006185.pub4. Review. PubMed PMID: 28488268; PubMed Central PMCID: PMC6481755.
  4. Saeys W, Truijen S (2019). The effect of trunk exercises on the perception of verticality after stroke: A pilot study, Neurol Rehabil 2019; 25, S37-S41, KV1-08; Hippocampus Verlag, DOI: 10.14624/NR1904007.

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