School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
J Rehabil Med. 2011 Jun;43(7):565-71. doi: 10.2340/16501977-0824.
To examine the effectiveness of group circuit class therapy for improving the mobility of adults after stroke.
Cochrane systematic review.
A comprehensive search strategy was used to find randomized and quasi-randomized controlled trials of adults post-stroke receiving circuit class therapy. Two authors independently selected trials for inclusion, assessed the methodological rigor and extracted data.
Six trials were included, involving 292 participants; most were community-dwelling survivors who were able to walk independently. Circuit class therapy was effective in improving walking ability (6-minute walk test mean difference, 76.6 m, 95% confidence interval 38.4-114.7, walking speed mean difference 0.12 m/s, 95% confidence interval 0-0.24) and balance (step test mean difference 3.0 steps, 95% confidence interval 0.08-5.9, activities specific balance confidence mean difference 7.76 points, 95% confidence interval 0.66-14.9). Other balance measures did not show a difference in effect. Results from two studies suggest that circuit class therapy can reduce length of hospital stay (mean difference -19.7 days, 95% confidence interval -35.4 to -4.0). Two studies measured adverse events (falls); all were minor.
Circuit class therapy is safe and effective in improving mobility in people after stroke and, when provided as part of hospital-based rehabilitation, may reduce length of stay.
考察团体循环训练疗法对改善脑卒中后成人活动能力的效果。
Cochrane 系统评价。
采用全面检索策略寻找脑卒中后接受循环训练疗法的成人随机和准随机对照试验。两位作者独立选择试验进行纳入、评估方法学严谨性并提取数据。
纳入 6 项试验，涉及 292 名参与者；多数为能独立行走的社区居住幸存者。循环训练疗法在改善行走能力（6 分钟步行测试平均差值 76.6 m，95%置信区间 38.4-114.7，行走速度平均差值 0.12 m/s，95%置信区间 0-0.24）和平衡能力（步测试平均差值 3.0 步，95%置信区间 0.08-5.9，特定活动平衡信心平均差值 7.76 分，95%置信区间 0.66-14.9）方面有效。其他平衡测量指标的效果无差异。两项研究的结果表明，循环训练疗法可缩短住院时间（平均差值-19.7 天，95%置信区间-35.4 至-4.0）。两项研究测量了不良事件（跌倒）；均为轻微事件。
团体循环训练疗法安全且有效，可改善脑卒中后患者的活动能力，并且作为医院康复的一部分，可能会缩短住院时间。
