Neuroplasticity and Functional Gains with Task-Specific Circuit Training in Stroke Patients

Abstract

Objective: The objective of this research was to investigate the efficacy of task-specific circuit training in rehabilitating upper extremity rehabilitation in patients with middle cerebral artery (MCA) stroke. Background: Stroke is a leading health problem worldwide and often results in long-term disabilities, including the loss of upper limb function. Limitations in mobility following a stroke can lead to reduced physical activity levels. The impact of task-specific circuit training, an intervention method that emphasizes the practice of functional tasks, on the upper extremity function of individuals who have experienced a stroke in the middle cerebral artery (MCA).

Methodology:A pilot study with a pre-post test study design was conducted  at the outpatient physiotherapy department of ACS Medical College and Hospital. To select participants, a random sampling method was employed, resulting in a sample of 10 stroke patients aged between 40 and 65 years. The inclusion criteria consisted of individuals who had suffered their initial stroke within the past 2-6 months, had experienced a first unilateral infarction, and exhibited a Brunnstrom stage of recovery in the proximal and distal regions of the affected upper extremity of 3 or below.

Both males and females were included in the study. Patients with cognitive impairment, dementia, previous orthopedic or neurological problems affecting the upper limb (e.g., severe arthritis, polyneuritis), severe heart disease, and other adverse health conditions that might affect their performance in the intervention (e.g., vestibular disturbance) were excluded. The intervention comprised a 12-week program combining task-specific circuit training with conventional physiotherapy. Participants engaged in training sessions five times per week, each lasting 40 minutes, while conventional physiotherapy sessions lasted 20 minutes per session over the same duration. The research utilized the Chedoke Arm and Hand Activity Inventory Scale (CAHAI-13) and electromyography (EMG) to assess the results.

Results: The findings revealed a significant and substantial disparity in average CAHAI-13 scores within the task-specific circuit training group, with the pre-test average being 48.50 and the post-test average being 51.50. This difference was highly significant, leading us to reject the null hypothesis with a p-value of less than or equal to 0.001. The results of the post-test assessments demonstrated a noticeable enhancement in upper limb function when compared to the pre-test measurements. Likewise, the EMG scores for the biceps, triceps, extensor digitorum, and deltoid (middle) exhibited highly significant differences within the task-specific circuit training group between the pre-test (585.38, 271.63, 389.00, 668.00) and post-test (456.50, 187.63, 266.00, 512.38), leading to the rejection of the null hypothesis (p ≤ 0.001). Moreover, there were extremely notable differences within the same group between the initial assessment and subsequent evaluation (p ≤ 0.001).

Conclusion: To summarize, the research determined  task-specific circuit training was successful in improving upper limb function among individuals who had experienced an MCA stroke. The results, which were reinforced by notable enhancements in CAHAI-13 scores and EMG measurements, underscore the promising potential of task-specific circuit training as an successful treatment for rehabilitating the upper extremities of MCA CVA patients.