Samenvatting

Background. Stroke is considered to be one of the leading causes of impairment and disability throughout Western society. Each year millions of stroke survivors have to adapt to a new lifestyle, with 25-74% in need of some assistance and a great proportion losing their ability to walk. Recently, Circuit Class Therapy (CCT) has been introduced as an effective and cost saving method to treat stroke patients.

Objective. To find out, if CCT is more effective to improve the walking function, in terms of walking speed and distance, for the post acute and chronic stages of stroke than usual physiotherapy.

Research question. Does CCT show better outcomes, in terms of walking speed and distance, compared to usual physiotherapy according to the Dutch physiotherapy guideline?

Method. Potentially relevant articles were identified on various databases based on set inclusion and exclusion criteria. The selected literature was assessed based on its methodological quality using the PEDro scale. A best evidence synthesis was applied in order to come to an overall finding of the level of evidence.

Results. Seven articles, presenting with a "Good" or "Very Good" quality were found. The best evidence synthesis was applied separately according to the control interventions of the studies. Strong evidence was found that CCT significantly improves walking distance compared to upper limb exercises. Limited evidence was reported that CCT is more effective than relaxation and social educational sessions, usual outpatient physiotherapy and Bobath treatment to increase walking distance. Limited or no evidence exists that CCT significantly improves walking speed compared to the control interventions.

Conclusion. CCT is a therapy form, which can easily be applied in various health care settings. It has shown to be an effective method to improve walking competency with a lower ratio of staff per patients and therefore being a cost saving method.