Effectiveness of a structured circuit class therapy model in stroke rehabilitation: a protocol for a randomised controlled trial

BACKGROUND: Currently, the key advocacy in neuroscientific studies for stroke rehabilitation is that therapy should be directed towards task specificity performed with multiple repetitions. Circuit Class Therapy (CCT) is well suited to accomplish multiple task-specific activities. However, while repetitive task practice is achievable with circuit class therapy, in stroke survivors repetitive activities may be affected by poor neurologic inputs to motor units, resulting in decreases in discharging rates which consequently may reduce the efficiency of muscular contraction. To accomplish multiple repetitions, stroke survivors may require augmented duration of practice. To date, no study has examined the effect of augmented duration of CCT in stroke rehabilitation, and specifically what duration of CCT is more effective in influencing functional capacity among stroke survivors. METHODS/DESIGN: Using a randomised controlled trial with blinded outcome assessment, this study is aimed at determining the effectiveness of structured augmented CCT in stroke rehabilitation. Sixty-eight stroke survivors (to be recruited from a tertiary health institution in Kano, Northwest, Nigeria) will be randomised into one of four groups: three intervention groups of differing CCT durations namely: 60 min, 90 min, and 120minuntes respectively, and a control group. Participants will take part in an 8-week structured intensive CCT intervention. Participants will be assessed at baseline, post-intervention, and six-month follow-up for the effectiveness of the varied durations of therapy, using standardised tools. Based on the WHO-ICF model, the outcomes are body structure/function, activity limitation, and participation restriction measures. DISCUSSION: It is expected that the outcome of this study will clarify whether increasing CCT duration leads to better recovery of motor function in stroke survivors. TRIAL REGISTRATION: Pan African Clinical Trial Registry (PACTR): PACTR201311000701191