Article

Task-specificity, repetition and progression are key variables in the
acquisition of motor skill however they have not been consistently implemented in post-stroke rehabilitation. OBJECTIVE:
To evaluate the effectiveness of a stroke
rehabilitation plan of care that incorporated task-specific practice, repetition
and progression to facilitate functional gain compared to standard physical
therapy for individuals admitted to an inpatient stroke unit. METHODS: Individuals participated in either a circuit training (CTPT) model (n = 72)
or a
standard (SPT) model (n = 108) of physical therapy, 5 days/week. Each 60 minute
circuit training session, delivered according to severity level, consisted of
four functional mobility tasks. Daily exercise logs documented both task
repetition and progression. RESULTS: The CTPT model was successfully implemented
in an acute rehabilitation setting. The CTPT group showed a significantly greater
improved change in gait speed from hospital admission to discharge than the SPT
group (0.21 +/- 0.25 m/sec vs. 0.13 +/- 0.22 m/sec; p = 0.03). The difference
between groups occurred primarily among those who were ambulatory upon admission.
There were no significant differences between the two cohorts at 90 days
post-stroke as measured by the FONE-FIM, SF-36 and living location. CONCLUSIONS:
Therapy focused on systematically progressed functional tasks can be successfully
implemented in an inpatient rehabilitation stroke program. This circuit-training
model resulted in greater gains in gait velocity over the course of inpatient
rehabilitation compared to the standard model of care. Community-based services
following hospital discharge to maintain these gains should be included in the
continuum of post-stroke care.

Langue : ANGLAIS