Group-based circuit training to improve mobility after stroke: a cross-sectional survey of German and Austrian physical therapists in outpatient settings

Article type: Research Article

Authors: Diermayr, Gudrun^{a; 1; *} | Greisberger, Andrea^{b; 2} | Stadel, Maria^{a; 3} | Garbade, Sven^{c; 4} | Salbach, Nancy M.^{d; 5}

Affiliations: [a] School of Therapeutic Sciences, SRH University Heidelberg, Heidelberg, Germany | [b] Department of Health Sciences, University of Applied Sciences Campus Vienna, Vienna, Austria | [c] Division of Pediatric Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany | [d] Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada

Correspondence: [*] Address for correspondence: Gudrun Diermayr, School of Therapeutic Sciences, SRH University Heidelberg, Heidelberg, Germany. E-mail: gudrun.diermayr@srh.de.

Note: [1] ORCID: 0000-0002-4534-7855.

Note: [2] ORCID: 0000-0002-0858-4819.

Note: [3] ORCID: 0000-0003-1333-4272.

Note: [4] ORCID: 0000-0002-7420-4757.

Note: [5] ORCID: 0000-0002-6178-0691.

Abstract: BACKGROUND:A contextual transferability analysis identified group-based circuit training (GCT) as an optimal intervention in German and Austrian outpatient physical therapy to improve mobility post-stroke. GCT incorporates task-oriented, high-repetitive, balance, aerobic and strength training and allows for increased therapy time without increasing personnel. OBJECTIVE:To determine the extent to which German and Austrian physical therapists (PTs) use GCT and its components in the outpatient treatment of stroke-related mobility deficits and to identify factors associated with using GCT components. METHODS:A cross-sectional online survey was conducted. Data were analyzed descriptively and using ordinal regression. RESULTS:Ninety-three PTs participated. None reported using GCT moderately to frequently (4–10/10 patients). The percentage of PTs reporting frequent use (7–10/10 patients) of task-oriented, balance, strength, aerobic, and high-repetitive training was 45.2%, 43.0%, 26.9%, 19.4%, and 8.6%, respectively. Teaching or supervising students, time for evidence-based practice activities at work, and working in Austria was associated with using GCT components frequently. CONCLUSION:German and Austrian PTs do not yet use GCT in outpatient physical therapy for stroke. Almost half of PTs, however, employ task-oriented training as recommended across guidelines. A detailed, theory-driven and country-specific evaluation of barriers to GCT uptake is necessary to inform implementation.

Keywords: Stroke, physical therapists, translational science, biomedical, circuit-based exercise, guideline adherence

DOI: 10.3233/NRE-230010

Journal: NeuroRehabilitation, vol. 53, no. 1, pp. 105-119, 2023