Task-oriented Circuit Training Research Articles

Co-design of a walking activity intervention for stroke survivors.

Stroke survivors may not maintain gains made in gait performance after task-oriented circuit training. Behavior change interventions may enhance the long-term adoption of physical activity. This study uses a co-design methodology to develop an intervention and tools to facilitate physical and exercise therapists in supporting an active lifestyle in stroke survivors, which is defined as a lifestyle that integrates daily walking performance with day-to-day activity. (1) To describe the insights generated during the co-design process; and (2) To describe the tools that were developed during the co-design process. A multidisciplinary team consisting of staff members of the Royal Dutch Society for Physical Therapy, exercise and physical therapists specializing in neurorehabilitation and conducting task-oriented circuit class training in primary care settings or day therapy centers within residential care facilities, stroke survivors and their carers, experts in measuring movement behavior in stroke survivors, a company specializing in manufacturing sensors and related software, behavior change specialists, and co-designers all collaborated in a three-stage (define, develop, and deliver) co-design process. In the design process, the team iteratively developed a prototype accelerometer system for measuring walking performance with a feedback function for stroke survivors and their therapists and a prototype toolbox for therapists to support the facilitation of behavior change in their stroke survivors. This study shows how co-design can be applied to develop interventions for stroke survivors. Both the prototype system for measuring walking performance and the toolbox incorporate behavior change techniques to support a more physically active lifestyle in stroke survivors. Further research will investigate the feasibility of the intervention.

The effects of myofascial release in combined with task-oriented circuit training on balance in people with Parkinson’s disease: a randomized pilot trial

ABSTRACT Objectives Task-oriented circuit training (TOCT) has been used to improve balance in people with Parkinson’s disease (pwPD). To investigate the effectiveness of TOCT on balance, quality of life, and disease symptoms when combined with myofascial release in pwPD. Methods Twenty-six pwPD were randomized into two groups for this randomized controlled study. The groups received TOCT three days a week for eight weeks. At the end of each session, the myofascial release was applied to the neck, trunk, and lumbar region with three sets of 60-s foam rolling body weight (Intervention group-IG) and perceived discomfort level 0/10 (Control group-CG) using a numeric rating scale. Primary outcome measures were measured by the Berg Balance Scale (BBS), Parkinson’s Disease Questionnaire (PDQ-8), and Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Secondary outcome measures included posturographic assessment, timed-up and go test (TUG), Trunk Impairment Scale (TIS), and rolling time. Results Data obtained from 26 pwPDs in equal numbers in both groups were analyzed. All groups reported a significant change in MDS-UPDRS, MDS-UPDRS-III, PDQ-8, TIS, and rolling time after treatment compared to pretreatment. Post-hoc analyses showed that IG significantly improved motor symptoms, TUG, and TIS dynamics compared to CG. The mediolateral limits of stability and anterioposterior limits of stability distances of IG increased (p < 0.05). Discussion Myofascial release, when combined with TOCT, may help to reduce disease-related motor symptoms and improve dynamic balance in pwPD. These findings suggest that myofascial release can be a beneficial addition to TOCT programs for pwPD. Clinical Trial Number: NCT05900934 (ClinicalTrials.gov).

Comparison of Nonimmersive Virtual Reality and Task-Oriented Circuit Training on Gait, Balance, and Cognition Among Elderly Population: A Single-Blind Randomized Control Trial.

Purpose: The purpose of this study was to determine the effects of nonimmersive virtual reality (VR) and task-oriented circuit training on gait, balance, cognitive domains, and quality of life among the elderly population. Methods: This is a single-blind randomized control trial in which 28 elderly individuals between 60 and 75 years were selected. The participants were divided into two groups, task-oriented circuit training and the other receiving nonimmersive VR treatment, with 14 participants in each group. To analyze the effects of both training on balance and gait time up and go test (TUGT), dynamic gait index (DGI), measures were used and for cognitive domains Montreal cognitive assessment (MoCA) scale was used. Short form 12 (SF-12) (along with two domains, Physical Component Summary and Mental Component Summary) was used for the measurement of quality of life. The treatment duration was 8 weeks for both groups. Both the pre-test and post-test readings were analyzed and compared. Results: The mean age of participants was 66.91 ± 3.79 years. Within-group comparison between the pre-test and post-test indicated that significant differences (P < 0.05) existed in all the outcome measures (TUGT, DGI, MoCA, and SF-12) in both groups. However, between-group comparison, significant differences were only found in TUGT and DGI in nonimmersive VR group. Conclusion: This study concluded that both interventions nonimmersive VR and task-oriented circuit training were beneficial for improving balance, gait, quality of life, and cognitive domains like memory, attention spans, executive functions, and so on in elderly population. However nonimmersive virtual reality training is a more effective, feasible, and safe alternative and can be proposed as a form of fall prevention exercise for the older adults. ClinicalTrials.gov Identifier: NCT05021432.

Combined effects of cerebellar tDCS and task-oriented circuit training in people with multiple sclerosis: A pilot randomized control trial.

Balance and mobility impairments are frequent in people with multiple sclerosis, partly due to cerebellar dysfunctions. Task-oriented behavioural approaches were previously shown to promote physical function. The possibility exists that cerebellar transcranial direct current stimulation (ctDCS) applied during training, known to increase the excitability of the brain, can boost rehabilitation effects through modulation of cerebellum-brain inhibition. To test the efficacy of cerebellar ctDCS stimulation combined with motor training on mobility and balance in people with multiple sclerosis. 16 subjects were randomly assigned to receive real- or sham-ctDCS and task-oriented training daily over two weeks in a double-blind, randomised clinical pilot trial. Functional mobility, balance, walking performance and quality of life were tested before and after treatment and at two-week follow-up. Effects of cerebellar stimulation on psychological and executive functions were also recorded. Walking performance, balance and quality of life improved for both groups at post-treatment assessment which was maintained at 2-weeks follow up. A two-way ANOVA revealed a significant time effect for balance and walking performance. A significant interaction effect of time-treatment (F = 3.12, df = 2,26; p = 0.03) was found for motor aspects of quality of life assessment in patients who received real-ctDCS. Task-oriented training improves balance and mobility in people with multiple sclerosis, but ctDCS does not boost motor training effects.

Combining a supervised and home-based task-oriented circuit training improves walking endurance in patients with multiple sclerosis. The MS_TOCT randomized-controlled trial

BackgroundBalance and mobility impairments are widespread in patients with Multiple Sclerosis (PwMS), even at an early stage. They can contribute to disability, physical deconditioning and reduced quality of life. Task-oriented is a training modality that may promote walking abilities and conditioning. However, the effects usually are short-lasting and exercising at home can have several barriers. This randomized controlled trial aimed to test the effectiveness of the combination of a 2-weeks in-person, supervised task-oriented circuit training (TOCT), followed by a 12-weeks home-based task-oriented program with monthly in-person visits. Methods36 PwMS with EDSS 4–5.5 and unassisted walking have been randomly assigned to 10 supervised TOCT sessions over two weeks (Phase 1) followed by a 12-weeks home-based task-oriented program (Phase 2) or a delayed-treatment group. At the end of Phase 2, the delayed-treatment group (usual care) received the same TOCT protocol. Phase 1 was composed of six gait-based workstations and treadmill training, whereas Phase 2 was based on progressive task-oriented tasks practice at home with monthly visits to adjust activities levels. Six Minute Walk Test (6MWT), Timed 25-foot walk test (T25FW), Timed Up and Go test (TUG), Dynamic Gait Index (DGI), Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Walking Scale – 12 (MSWS-12), Multiple Sclerosis Impact Scale–29 (MSIS-29) and resting muscle oxygen consumption (rmVO2) were assessed as outcome measures at baseline, after Phase 1 and after Phase 2. Retention was tested on the whole sample at a 12-weeks follow-up. ResultsThe entire sample completed the 2-weeks TOCT, whereas adherence was good for the 12-weeks home-based task-oriented program (6.2/10). The mean repetitions and level of difficulty of each task significantly increased after every timepoint. A superiority of task-oriented program was verified for 6MWT (F, 2,88 = 7.80; p<0.001) on usual care after the 12-weeks home-based program. Moreover, between-group differences were highlighted at the same point, even for T25FW, TUG and MSWS-12. RmVO2 and fatigue were significantly improved only in the experimental group. Positive effects on 6MWT were retained 12 weeks after the end of the protocol (p<0.001) in the whole sample. ConclusionsThe combination of a supervised and self-managed task-oriented program enhances walking endurance with positive effects on walking ability, fatigue and resting muscle oxygen consumption in PwMS with unassisted walking. These preliminary results reflected how this intervention was effective for impairment and activity improvements; moreover, it was cardiorespiratory stressful and possibly reduced deconditioning.

Effects of Game-Based Task-Oriented Circuit Training on Physical Functions of Stroke Survivors: A Pilot Study in A State Hospital in Kelantan, Malaysia

Despite being increasingly popular and commonly used in rehabilitation, both game-based exercise training and task-oriented circuit training have never been combined to provide a new training experience for stroke survivors undergoing rehabilitation. Past studies have assessed the effectiveness of these exercise approaches separately and reported positive outcomes. Combining the two training programs may create a more enriched environment and yield favorable outcomes. The aim of this study was to determine the effects of game-based task-oriented circuit training on the physical functions of stroke survivors. This research was a pretest-posttest experimental pilot trial involving 30 participants at post-acute and chronic stage post-stroke (mean age and standard deviation = 58.9 ± 6.6 years; mean Montreal Cognitive Assessment scoring = 23.4 ± 7.1) conducted at a state hospital in Kelantan, Malaysia between August 2019 to February 2020. All participants received game-based task-oriented circuit training using a “Checkercise Board” for 45 minutes, twice per week for 8 weeks. The outcome of the training was measured with regard to lower limb strength, functional stability and aerobic capacity, with the use of the 30-second chair rise test, Dynamic Gait Index (DGI) and 6-minute walk test, respectively. Analysis was done by the ‘intention-to-treat’ approach, using paired samples t-test to determine the differences between pre and post-training outcomes scores. All data was analyzed using the Statistics Package for the Social Sciences (SPSS), version 23.0. The significance level was set at p &lt; 0.05 and Cohen’s (d) was used to determine the effect size. Post-training, participants’ mean 30-second chair rise test, DGI and 6-minute walk test scores increased by 9%, 7% and 23% respectively compared to pre-treatment (p &lt; 0.05), with medium effect size of 0.5 to 0.6. Game-based task-oriented circuit training effectively improves lower limb strength, functional stability and aerobic capacity of stroke survivors, and may be used as a therapy option for this population. A future study is needed to confirm these study finding.

Task-Oriented Circuit Training as an Alternative to Ergometer-Type Aerobic Exercise Training after Stroke.

Moderate-intensity aerobic exercise training is an important treatment strategy to enhance functional recovery and decrease cardiometabolic risk factors after stroke. However, stroke related impairments limit access to ergometer-type exercise. The aims of the current study were (1) to evaluate whether our task-oriented circuit training protocol (intermittent functional training; IFT) could be used to sustain moderate-intensity aerobic workloads over a 10-week intervention period, and (2) to investigate its preliminary effects on cardiorespiratory fitness and metabolic profiles compared to constant-load ergometer-type exercise (CET). Forty chronic hemiparetic stroke survivors were randomized to receive 30 sessions of IFT or CET over ten weeks. Similar proportions of participants were randomized to IFT (7/19) and CET (9/18) sustained workloads associated with moderate-intensity aerobic exercise over the study period (p = 0.515). However, CET was associated with more substantial changes in maximal oxygen uptake (MD = 2.79 mL min−1 kg−1 CI: 0.84 to 4.74) compared to IFT (MD = 0.62 mL min−1 kg−1 CI: −0.38 to 1.62). Pre to post changes in C-reactive protein (−0.9 mg/L; p =0.017), short-term glycemia (+14.7 µmol/L; p = 0.026), and resting whole-body carbohydrate oxidation (+24.2 mg min−1; p = 0.046) were observed when considering both groups together. Accordingly, IFT can replicate the aerobic intensities sustained during traditional ergometer-type exercise training. More work is needed to evaluate the dose–response effects of such task-oriented circuit training protocols on secondary prevention targets across the continuum of stroke recovery.

Perceived fatigue, lower limb muscle force and performance fatigability after a rehabilitation program in Multiple Sclerosis

Muscle weakness and fatigue represent frequent disabling symptoms for Multiple Sclerosis (MS) patients. We evaluated the effects of an intensive task-oriented circuit training (TOCT) on perceived fatigue, muscle strength and changes in motor performance fatigability in mildly impaired MS patients. Fifteen MS patients performed different functional scales, self-reported questionnaires and instrumental evaluations before (T0) and after (T1) TOCT. Strength and performance fatigability were analyzed during isometric knee extension and ankle dorsiflexion through an isokinetic dinamometer, recording surface EMG signals of Vastus Medialis and Tibialis Anterior. The Dinamic Gait Index, Multiple Sclerosis Impact Scale-29, Modified Fatigue Impact Scale and Multiple Sclerosis Walking Scale–12 significantly improved after training. An increase of exerted force during isometric knee extension was observed, whereas no significant changes were revealed on mechanical and electrical fatigue. Moreover, the improvement in perceived disability after treatment was related to strength increase in knee mechanical force output. The TOCT positively modifies perceived fatigue, perceived ambulatory function and knee force output in mildly impaired MS subjects, suggesting a virtuous circle between strength levels, recovery of functional skills and improved quality of life.

Progressive task-oriented circuit training for cognition, physical functioning and societal participation in individuals with dementia.

Dementia is commonly associated with cognitive deficit, functional decline and societal participation restriction across multiple domains of functioning. The decline impacts not only on the individual, but also on their informal caregivers, healthcare and the social system. This clinical random controlled study investigated the efficacy of 12-week Progressive Task-oriented circuit training on cognition, physical functioning and societal participation of individuals with dementia. This study involved 31 individuals living with dementia recruited from a tertiary health institution in Lagos Nigeria. They were randomized into two groups: Progressive Task-oriented circuit training (involved in 12-week circuit training, two times a week for 70 min per session consisting of six workstations) and Control group (training with conventional treatment and home programmes). They were assessed at baseline, mid-intervention and post-intervention using Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-Cognition (ADAS-Cog), Bristol ADLs, Community integration Questionnaire, 6-min walk test. Data analysed using the independent-samples t tests, paired t tests, Friedman two-way analysis of variance and Mann-Whitney U test (p ≤ .05). Participants were aged 69.61 ± 3.44 years. There was significant improvement from baseline to post-intervention in cognition (30.77 ± 1.02 vs. 28.77 ± 3.30), physical functioning (28.19 ± 3.90 vs. 25.84 ± 6.26) and societal participation (3.64 ± 0.73 vs. 5.59 ± 2.76). However, the progressive Task-oriented circuit training had more significant improvement than the control group within the group in cognition (p = .000), physical functioning (p = .000), and societal participation (p = .000). There was no statistical difference within the Control group with cognition (p = .097), Physical functioning (p = 1.000). Meanwhile there was statistically significant effect between both groups on cognition, physical functioning and societal participation post-intervention (p < .005). Although both Task-oriented Circuit Training and conventional treatment with home exercise programmes are efficacious, Progressive Task-oriented Circuit Training is more efficacious in enhancing and developing therapeutic strategies to train cognition, improve functional performance and societal participation in the rehabilitation of individuals with dementia.

Influence of task-oriented circuit training on upper limb function among rural community-dwelling survivors of stroke

Background Task-oriented circuit training using a Multi-Activities workstation emphasises goal-oriented tasks practiced in a circuit or series in order to learn a new skill. It can be used for upper limb rehabilitation among stroke patients in a community setting, but there is currently very little evidence available regarding its use in this patient group and setting. This study aimed to explore the influence of task-oriented circuit training using a Multi-Activities workstation on upper limb function among community-dwelling individuals with chronic stroke. Methods A pre-test–post-test study was conducted involving 17 community-dwelling individuals with chronic stroke who were attending a stroke rehabilitation centre. Six weeks of task-oriented circuit training was given using a Multi-Activities workstation aimed to improve strength, range of motion and dexterity. Streamlined Wolf Motor Function Test and Chedoke Arm and Hand Activity Inventory were used to measure outcomes. Wilcoxon signed-rank test was used for data analysis. Results A total of 12 sessions of task-oriented circuit training using Multi-Activities workstations did not result in any statistically significant differences in outcome measures. Conclusions Task-oriented circuit training using the Multi-Activities workstation did not improve upper limb function in community-dwelling individuals with chronic stroke.

Effect of task-oriented circuit training on motor and cognitive performance in patients with multiple sclerosis: A single-blinded randomized controlled trial.

Exercise training has positive effects on motor and cognitive performance which deteriorates over time in patients with Multiple Sclerosis (MS). The effects of task-oriented circuit training (TOCT) on motor and cognitive performance in patients with MS are not yet clear. The aims of this study are to investigate the effects of TOCT on balance, walking, manual dexterity, cognitive performance, and to determine the extent to which patients are able to transfer changes in their performance to activities of daily living. Twenty patients with MS (EDSS: 2-5.5), were randomly assigned to two groups; the task-oriented circuit training group (TOCTG, n:10) and the control group (CG, n:10). The TOCTG received TOCT twice a week for six weeks while the CG performed the relaxation exercises at home. All patients were assessed by using Modified Sensory Organization Test, Berg Balance Scale, Activities-specific Balance Confidence, Timed Up and Go, Functional Gait Assessment, 12-item Multiple Sclerosis Walking Scale, Nine-Hole Peg Test, Brief Repeatable Battery of Neuropsychological Tests, Multiple Sclerosis Neuropsychological Questionnaire. Balance and walking performance were improved after TOCT (p < 0.05), whereas manual dexterity and cognitive performance except for verbal memory did not change significantly (p > 0.05). The CG showed no changes in any measurements (p > 0.05). TOCT is quite effective to improve balance and walking in patients with MS. However, further studies are needed to determine the effect of TOCT on cognitive performance.

An intensive task-oriented circuit training positively impacts gait biomechanics in MS patients.

An intensive task-oriented circuit training (TOCT) provides a valid approach in improving motor function in Multiple Sclerosis (MS). We aimed at testing the efficacy of TOCT on gait kinematics in MS patients with mild-moderate disability. Nineteen MS patients able of independent walking performed 3-D Gait Analysis before (T0) and after (T1) a two-week TOCT program. Patients were clustered in two different subgroups, according to clinical neurological impairments assessed with specific functional system of Expanded Disability Status Scale (EDSS): pyramidal (Group 1) and cerebellar (Group 2) subjects. Spatio-temporal and kinematic data were compared before and after the TOCT intervention in the total sample of patients and in the two selected subgroups at two time intervals. Data obtained revealed increased dynamic ROM at knee joint after training in the whole study sample. Of note, knee dynamic excursion improved significantly in Group 1 but not in Group 2 patients after TOCT. Moreover, sagittal plane kinematics revealed significant modifications on knee and ankle biomechanics in Group 1 after rehabilitation. These data point out the benefits of the task specific training on gait dynamics in mild impaired MS subjects, linking to treatment opportunity in patients with a prevalent pyramidal impairment.

Task-Oriented Circuit Training for Mobility in Outpatient Stroke Rehabilitation in Germany and Austria: A Contextual Transferability Analysis.

People with stroke cite mobility deficits as one of the most burdensome limitations. National and international stroke guidelines recommend physical therapy based on task-oriented practice, with high numbers of repetitions to improve mobility. In the outpatient setting in Germany and Austria, these principles have not yet been established. The purpose of this study was to identify an evidence-based intervention that could help reduce this research-practice gap. A stepwise approach proposed by Voigt-Radloff and colleagues and Cochrane Germany was used. First, the specific health service problem in the German and Austrian physical therapy outpatient context was identified. Second, a promising intervention was identified using a systematic search in the Cochrane Library and by grading the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation. Finally, the transferability of the promising intervention into the local context was evaluated using predefined questions from the Cochrane guide and reports from health insurances, professional organizations, and national stroke guidelines. Task-oriented circuit training reviewed by English and colleagues was chosen. The review showed clinically important improvements in walking distance and speed. The quality of the evidence was graded high for these 2 outcomes. We identified contextual challenges for implementation at the setting level (eg, insufficient reimbursement for group therapy by insurance companies), the participant and therapist level (eg, unknown motivation for group therapy due to the established 1:1 patient-therapist ratio), and the outcome measure level (eg, lack of standardized, cross-culturally translated manuals). Although task-oriented circuit training is scientifically well established, barriers to implementation into routine care in Germany and Austria can be expected. In a next step, research using knowledge translation methodology will focus on the detailed evaluation of barriers and facilitators with relevant stakeholders.

Task-oriented circuit training combined with aerobic training improves motor performance and balance in people with Parkinson's Disease.

Goal-based training such as task practice combined with aerobic training (AT) has been suggested to improve motor performance and neuroplasticity for people with Parkinson's Disease (PwPD); however, its effect on clinical outcomes is unclear. Therefore, the main aim was to investigate the effects of task-oriented circuit training combined with AT (TOCT-AT) on balance and gait in PwPD. The secondary aim was to investigate the effects of TOCT-AT on functional mobility, balance confidence, disease severity, and quality of life. Twenty-six PwPD were randomly assigned to either to the experimental group (n = 14) or the control group (n = 12). The control group received AT, while the experimental group received TOCT-AT three times a week for 8weeks. The main outcomes were the Berg Balance Scale (BBS), Postural Stability Test (PST), Limits of Stability Test (LOS), Pull Test (PT), Six Minute Walk Test (6MWT), Timed Up and Go Test (TUG), Activities-specific Balance Confidence Scale (ABC), Unified Parkinson's Disease Rating Scale (UPDRS), and eight-item Parkinson's Disease Questionnaire (PDQ-8) were secondary outcomes. After intervention, between-group comparisons showed that the experimental group significantly improved more than the control group in all outcomes (p < 0.05). Additionally, both groups significantly improved in BBS, 6MWT, TUG, ABC, UPDRS-II, UPDRS-III, UPDRS total, and PDQ-8 (p < 0.05), while only the experimental group significantly improved in PST, LOS, and PT (p < 0.001). This study suggest that TOCT-AT could improve balance and gait performance, which could also be positively translated into functional mobility, balance confidence, disease severity, and quality of life in PwPD.

The Effects of Task-Oriented Circuit Training Using Rehabilitation Tools on the Upper-Extremity Functions and Daily Activities of Patients with Acute Stroke: A Randomized Controlled Pilot Trial.

ObjectivesThe purpose of this study was to investigate the effect of task-oriented circuit training (TOCT) using the rehabilitation tools for upper extremity function upon the daily life of patients with acute stroke.MethodsEighteen patients with acute stroke were randomly allocated into either the experimental group or the control group. The experimental group performed the TOCT program using rehabilitation tools, whilst the control group had neuro-developmental treatment. Both groups received 30 minutes of treatment per session, 5~6 times per week, for 4 weeks. The assessments conducted were the Fugl-Meyer assessment, motor activity log and stroke impact scale to compare the upper extremity function and activities of daily living.ResultsThe results showed a significant improvement in the TOCT group compared with the neuro-developmental treatment group in the amount of motor activity use and high stroke impact score, indicating recovery (p < 0.05).ConclusionThe TOCT program using rehabilitation tools could have a positive impact on acute stroke patients use of their upper extremity.

Predictive value of electroencephalography connectivity measures for motor training outcome in multiple sclerosis: an observational longitudinal study.

Neurophysiological investigations represent powerful tools to shed light on brain plasticity in multiple sclerosis (MS) patients. We investigated the relationship between electroencephalography (EEG)-based connectivity, the extent of brain lesions and changes in motor performance after an intensive task-oriented circuit training (TOCT). Observational longitudinal study. Outpatients training program. Sixteen MS patients (10F; mean age =51.4 years; range: 27-67; mean disease duration =15.1 years; range: 2-26; mean Expanded Disability Status Scale 4.4; range: 3.5-5.5), were included in our study. MS patients with mild gait impairment were evaluated through functional scales and submitted to TOCT. Resting-state EEG was performed before (T0) and after (T1) rehabilitation. Alpha-band weighted Phase Lag Index (wPLI) and broadband weighted Symbolic Mutual Information (wSMI) connectivity analyses were performed. White matter lesion load was measured using MRI prior to the TOCT. Neurophysiological and structural parameters were then related to behavioral changes. Dynamic Gait Index significantly improved after TOCT (F(1,14) =13.10, P=0.003). Moreover, the interaction between TOCT and age was observed for changes in Timed Up and Go (TUG) performance (F(1,14) = 7.75, P=0.015), indicating that older patients only benefited in this measure. Regarding the relationship between EEG connectivity and TOCT outcome, we observed positive correlations between changes in TUG and strength (P=0.017) and efficiency (Pone-tail =0.029) of alpha-band wPLI connectivity at T0. Such correlation was mainly driven by antero-posterior regional interactions (P=0.038), rather than by inter-hemispheric connectivity (P=0.089). Moreover, we observed a positive correlation between performance improvements and wSMI connectivity at T1 (P=0.001) as well as the difference between T0 and T1 (P=0.005). Lesion load percentage was not related to functional improvement after TOCT (Pone-tail=0.137). Results of the current study demonstrated that baseline alpha-band wPLI connectivity predicts TOCT outcome in MS patients. Moreover, broadband wSMI tracks neural changes that accompany treatment-related variations in motor performance. Our findings suggest that EEG-based connectivity measures may represent a potential tool for customizing rehabilitative management of the disease.

Treadmill Exercise is Superior to Task-Oriented Circuit Training on Gait Outcomes in Stroke Survivors

To investigate the effects of treadmill aerobic exercise (T-AEX) compared to task-oriented circuit training (Task-CT) on gait outcomes in chronic stroke survivors.

Six hours of task-oriented training optimizes walking competency post stroke: a randomized controlled trial in the public health-care system of South Africa

Objective: To evaluate a minimal dose intervention of six 1-hour sessions of task-oriented circuit gait training including a caregiver over a 12-week period to persons post stroke in the South African public health sector. Design: Stratified, single blinded, randomized controlled trial with three intervention groups. Participants: Persons post stroke (n = 144, mean age 50 years, 72 women), mean 9.5 weeks post stroke. Interventions: Task group (n = 51)—accompanied by a caregiver; task-oriented circuit gait training (to improve strength, balance, and task performance while standing and walking). Strength group (n = 45); strength training of lower extremities while sitting and lying. Control group (n = 48); one 90-minute educational session on stroke management. Measures: The six-minute walk test (6MinWT) was the primary outcome; the secondary outcomes included comfortable and fast gait speeds, Berg Balance Scale (BBS), and Timed Up and Go (TUG). Particpants evaluated at baseline, post intervention (12 weeks), and at follow-up 12 weeks later. Change scores were compared using generalized repeated measures analysis of variance (ANOVA). Results: Task group change scores for all outcomes post intervention and at follow-up were improved compared to the other groups (P-values between 0.000005 and 0.04). The change scores (mean, 1SD) between baseline and follow-up for the Task, Strength, and Control groups, respectively, were as follows: 6MinWT:119.52 m (81.92), 81.05 m (79.53), and 60.99 m (68.38); comfortable speed 0.35 m/s (0.23), 0.24 m/s (0.22), and 0.19 m/s (0.21); BBS: 9.94 (7.72), 6.93 (6.01), and 5.19 (4.80); and TUG: –14.24 seconds (16.86), –6.49 seconds (9.88), and –5.65 seconds (8.10). Conclusion: Results support the efficacy of a minimal dose task-oriented circuit training program with caregiver help to enhance locomotor recovery and walking competency in these persons with stroke.

The effects of task-oriented circuit training on the upper extremity function and quality of life in chronic stroke patients

The effects of task-oriented circuit training on the upper extremity function and quality of life in chronic stroke patients

Effects of task-oriented circuit training on balance and gait ability in subacute stroke patients: a randomized controlled trial.

[Purpose] The aim of this study was to investigate the effects of the task-oriented circuit training on balance and gait ability in subacute patients with stroke. [Subjects and Methods] Participants were randomly allocated to two groups: group 1 (subjects who performed task-oriented circuit training) and group 2 (subjects who underwent conventional physical therapy). Berg balance scale, timed up and go test, functional ambulation category, 6-minute walk test were assessed before and after four weeks of training. [Results] There were significant differences between groups for the 6-minute walk test. [Conclusion] The result of this study showed that task-oriented circuit training could improve the gait ability in patients with subacute stroke.