Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 12 , Pages 1989-1996 , December 2009

Circuit-Based Rehabilitation Improves Gait Endurance but Not Usual Walking Activity in Chronic Stroke: A Randomized Controlled Trial

  • Suzie Mudge, PhD

      Affiliations

    • School of Rehabilitation and Occupation Studies, AUT University, University of Auckland, Auckland, New Zealand
    • Corresponding Author InformationReprint requests to Suzie Mudge, PhD, School of Rehabilitation and Occupation Studies, AUT University, Private Bag 92006, Auckland 1142, New Zealand
    • ,
  • P. Alan Barber, PhD

      Affiliations

    • Department of Medicine, University of Auckland, Auckland, New Zealand
    • ,
  • N. Susan Stott, PhD

      Affiliations

    • Department of Surgery, University of Auckland, Auckland, New Zealand

References 

  1. Adamson J, Beswick A, Ebrahim S. Is stroke the most common cause of disability?. J Stroke Cerebrovasc Dis. 2004;13:171–177
  2. Bonita R, Solomon N, Broad JB. Prevalence of stroke and stroke-related disability: estimates from the Auckland stroke studies. Stroke. 1997;28:1898–1902
  3. Kelly-Hayes M, Beiser A, Kase CS, Scaramucci A, D'Agostino RB, Wolf PA. The influence of gender and age on disability following ischemic stroke: the Framingham study. J Stroke Cerebrovasc Dis. 2003;12:119–126
  4. Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS. Stroke: neurologic and functional recovery: the Copenhagen Stroke Study. Phys Med Rehabil Clin North Am. 1999;10:887–906
  5. Leroux A. Exercise training to improve motor performance in chronic stroke: effects of a community-based exercise program. Int J Rehabil Res. 2005;28:17–23
  6. Eng JJ, Chu KS, Kim CM, Dawson AS, Carswell A, Hepburn KE. A community-based group exercise program for persons with chronic stroke. Med Sci Sports Exerc. 2003;35:1271–1278
  7. Latham NK, Jette DU, Slavin M, et al. Physical therapy during stroke rehabilitation for people with different walking abilities. Arch Phys Med Rehabil. 2005;86(12 Suppl 2):S41–S50
  8. Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. Arch Phys Med Rehabil. 2000;81:409–417
  9. Duncan P, Studenski S, Richards L, et al. Randomized clinical trial of therapeutic exercise in subacute stroke. Stroke. 2003;34:2173–2180
  10. Salbach NM, Mayo NE, Wood-Dauphinee S, Hanley JA, Richards CL, Cote R. A task-orientated intervention enhances walking distance and speed in the first year post stroke: a randomized controlled trial. Clin Rehabil. 2004;18:509–519
  11. Ada L, Dean CM, Hall JM, Bampton J, Crompton S. A treadmill and overground walking program improves walking in persons residing in the community after stroke: a placebo-controlled, randomized trial. Arch Phys Med Rehabil. 2003;84:1486–1491
  12. Eng JJ, Tang PF. Gait training strategies to optimize walking ability in people with stroke: a synthesis of the evidence. Expert Rev Neurother. 2007;7:1417–1436
  13. van de Port IG, Wood-Dauphinee S, Lindeman E, Kwakkel G. Effects of exercise training programs on walking competency after stroke: a systematic review. Am J Phys Med Rehabil. 2007;86:935–951
  14. Pang MY, Eng JJ, Dawson AS, McKay HA, Harris JE. A community-based fitness and mobility exercise program for older adults with chronic stroke: a randomized, controlled trial. J Am Geriatr Soc. 2005;53:1667–1674
  15. Bohannon RW. Muscle strength and muscle training after stroke. J Rehabil Med. 2007;39:14–20
  16. ACSM. American College of Sports Medicine Position Stand on progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2002;34:364–380
  17. Ouellette MM, LeBrasseur NK, Bean JF, et al. High-intensity resistance training improves muscle strength, self-reported function, and disability in long-term stroke survivors. Stroke. 2004;35:1404–1409
  18. Ada L, Dorsch S, Canning CG. Strengthening interventions increase strength and improve activity after stroke: a systematic review. Aust J Physiother. 2006;52:241–248
  19. Kim CM, Eng JJ, MacIntyre DL, Dawson AS. Effects of isokinetic strength training on walking in persons with stroke: a double-blind controlled pilot study. J Stroke Cerebrovasc Dis. 2001;10:265–273
  20. Olney SJ, Nymark J, Brouwer B, et al. A randomized controlled trial of supervised versus unsupervised exercise programs for ambulatory stroke survivors. Stroke. 2006;37:476–481
  21. Moreland JD, Goldsmith CH, Huijbregts MP, et al. Progressive resistance strengthening exercises after stroke: a single-blind randomized controlled trial. Arch Phys Med Rehabil. 2003;84:1433–1440
  22. Taylor D, Stretton C, Mudge S, Garrett N. Does clinic-measured gait speed differ from gait speed measured in the community in people with stroke?. Clin Rehabil. 2006;20:438–444
  23. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36), I: conceptual framework and item selection. Med Care. 1992;30:473–483
  24. Shaughnessy M, Michael KM, Sorkin JD, Macko RF. Steps after stroke: capturing ambulatory recovery. Stroke. 2005;36:1305–1307
  25. Haeuber E, Shaughnessy M, Forrester LW, Coleman KL, Macko RF. Accelerometer monitoring of home- and community-based ambulatory activity after stroke. Arch Phys Med Rehabil. 2004;85:1997–2001
  26. Michael KM, Allen JK, Macko RF. Reduced ambulatory activity after stroke: the role of balance, gait, and cardiovascular fitness. Arch Phys Med Rehabil. 2005;86:1552–1556
  27. Michael K, Macko RF. Ambulatory activity intensity profiles, fitness, and fatigue in chronic stroke. Top Stroke Rehabil. 2007;14:5–12
  28. Mudge S, Stott NS, Walt SE. Criterion validity of the StepWatch Activity Monitor as a measure of walking activity in patients after stroke. Arch Phys Med Rehabil. 2007;88:1710–1715
  29. Macko RF, Haeuber E, Shaughnessy M, et al. Microprocessor-based ambulatory activity monitoring in stroke patients. Med Sci Sports Exerc. 2002;34:394–399
  30. Mudge S, Stott NS. Test-retest reliability of the StepWatch Activity Monitor outputs in individuals with chronic stroke. Clin Rehabil. 2008;22:871–877
  31. Hill K, Miller K, Denisenko S, Clements T, Batchelor F. Manual for clinical outcome measurement in adult neurological physiotherapy. 2nd ed.. St Kilda: Australian Physiotherapy Association; 2001;
  32. Pang MY, Eng JJ, Dawson AS. Relationship between ambulatory capacity and cardiorespiratory fitness in chronic stroke: influence of stroke-specific impairments. Chest. 2005;127:495–501
  33. Mudge S, Stott S. Outcome measures to assess walking ability following stroke—a systematic review of the literature. Physiotherapy. 2007;93:189–200
  34. Flansbjer U, Holmback AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med. 2005;37:75–82
  35. Pal J, Hale LA, Skinner MA. Investigating the reliability and validity of two balance measures in adults with stroke. Int J Ther Rehabil. 2005;12:308–315
  36. Botner EM, Miller WC, Eng JJ. Measurement properties of the Activities-Specific Balance Confidence Scale among individuals with stroke. Disabil Rehabil. 2005;27:156–163
  37. Rimmer JH, Rubin SS, Braddock D, Hedman G. Physical activity patterns of African-American women with physical disabilities. Med Sci Sports Exerc. 1999;31:613–618
  38. Rimmer JH, Riley BB, Rubin SS. A new measure for assessing the physical activity behaviors of persons with disabilities and chronic health conditions: the Physical Activity and Disability Survey. Am J Health Promot. 2001;16:34–42
  39. Hollis S, Campbell F. What is meant by intention to treat analysis? (Survey of published randomised controlled trials). BMJ. 1999;319:670–674
  40. van den Berg-Emons R, Balk A, Bussmann H, Stam H. Does aerobic training lead to a more active lifestyle and improved quality of life in patients with chronic heart failure?. Eur J Heart Fail. 2004;6:95–100
  41. Shaughnessy M, Resnick BM, Macko RF. Testing a model of post-stroke exercise behavior. Rehabil Nurs. 2006;31:15–21
  42. Westerterp KR, Plasqui G. Physical activity and human energy expenditure. Curr Opin Clin Nutr Metab Care. 2004;7:607–613
  43. Westerterp KR, Meijer GA, Janssen EM, Saris WH, Ten Hoor F. Long-term effect of physical activity on energy balance and body composition. Br J Nutr. 1992;68:21–30
  44. Van Etten LM, Westerterp KR, Verstappen FT, Boon BJ, Saris WH. Effect of an 18-wk weight-training program on energy expenditure and physical activity. J Appl Physiol. 1997;82:298–304
  45. Meijer EP, Westerterp KR, Verstappen FT. Effect of exercise training on total daily physical activity in elderly humans. Eur J Appl Physiol Occup Physiol. 1999;80:16–21
  46. Meijer EP, Westerterp KR, Verstappen FT. Effect of exercise training on physical activity and substrate utilization in the elderly. Int J Sports Med. 2000;21:499–504
  47. Goran MI, Poehlman ET. Endurance training does not enhance total energy expenditure in healthy elderly persons. Am J Physiol. 1992;263(5 Pt 1):E950–E957
  48. Dean CM, Richards CL, Malouin F. Walking speed over 10 metres overestimates locomotor capacity after stroke. Clin Rehabil. 2001;15:415–421
  49. Arnett SW, Laity JH, Agrawal SK, Cress ME. Aerobic reserve and physical functional performance in older adults. Age Ageing. 2008;37:384–389
  50. Michael KM, Allen JK, Macko RF. Fatigue after stroke: relationship to mobility, fitness, ambulatory activity, social support, and falls efficacy. Rehabil Nurs. 2006;31:210–217
  51. Bohannon RW. Number of pedometer-assessed steps taken per day by adults: a descriptive meta-analysis. Phys Ther. 2007;87:1642–1650
  52. Green J, Forster A, Bogle S, Young J. Physiotherapy for patients with mobility problems more than 1 year after stroke: a randomised controlled trial. Lancet. 2002;359:199–203
  53. Shumway-Cook A, Patla A, Stewart A, Ferrucci L, Ciol MA, Guralnik JM. Environmental components of mobility disability in community-living older persons. J Am Geriatr Soc. 2003;51:393–398
  54. Patla A, Shumway-Cook A. Dimensions of mobility: defining the complexity and difficulty associated with community walking. J Aging Phys Act. 1999;7:7–19
  55. World Health Organization. International classification of functioning, disability and health: ICF. Geneva: World Health Organization; 2001;

 Supported by the Neurological Foundation, the New Zealand Society of Physiotherapists' Scholarship Fund, and the Health Research Council. The research was conducted during tenure of a Clinical Research Training Fellowship from the Health Research Council of New Zealand.

 Trial registration number: ACTRN12607000081415 on the Australian New Zealand Clinical Trials Registry at http://www.anzctr.org.au/default.aspx.

 No commercial party having a direct financial interest in the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(09)00680-7

doi: 10.1016/j.apmr.2009.07.015

Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 12 , Pages 1989-1996 , December 2009

Article Tools

* Image Usage & Resolution