Structured progressive circuit class therapy (Spcct) was developed based on task-oriented therapy, providing benefits to patients' motivation and motor function. Training with Motor Imagery (MI) alone can improve gait performance in stroke survivors, but a greater effect may be observed when combined with SPCCT. Health education (HE) is a basic component of stroke rehabilitation and can reduce depression and emotional distress. Thus, this study aimed to investigate the effect of MI with SPCCT against HE with SPCCT on gait in stroke survivors. Two hundred and ninety stroke survivors from 3 hospitals in Yangon, Myanmar enrolled in the study. Of these, 40 stroke survivors who passed the selection criteria were randomized into an experimental (n = 20) or control (n = 20) group. The experimental group received MI training whereas the control group received HE for 25 minutes prior to having the same 65 minutes SPCCT program, with both groups receiving training 3 times a week over 4 weeks. Temporo-spatial gait variables and lower limb muscle strength of the affected side were assessed at baseline, 2 weeks, and 4 weeks after intervention. After 4 weeks of training, the experimental group showed greater improvement than the control group in all temporospatial gait variables, except for the unaffected step length and step time symmetry which showed no difference. In addition, greater improvements of the affected hip flexor and knee extensor muscle strength were found in the experimental group. In conclusion, a combination of MI with SPCCT provided a greater therapeutic effect on gait and lower limb muscle strengths in stroke survivors.

Background and purposeSpatio‐temporal parameters are commonly used in gait assessment. Advanced tools provide valid and reliable data, considered very effective for physiotherapy intervention. However, these tools may be limited in clinical usage caused by complicated applicability, inaccessibility, and high cost. Therefore, a video‐based system is an alternative choice that is easy and affordable for the clinical setting. The purpose of the study was to evaluate the concurrent validity of the video‐based system against the validated instrumented gait system (Force Distribution Measurement [FDM]) on the spatio‐temporal gait parameters in individuals with stroke. In addition, the intratester reliability of a novice tester was determined.MethodsTwenty individuals with stroke participated in the study. Gait was captured by the video‐based and FDM systems simultaneously to measure the degree of concurrent validity. Parameters composed of the affected and unaffected step lengths (cm) and step time (s), stride length (cm), gait velocity (m/s), and cadence (steps/min). Pearson correlation coefficient, paired t test, and intraclass correlation coefficient (ICC) were used to determine the concurrent validity, the difference of the data, and intratester reliability.ResultsAll spatio‐temporal gait parameters showed excellent degrees of correlation (rp = .94 to.99, p <.001) between the video‐based and FDM systems. No significant difference in all parameters was found between the two systems. Excellent intratester reliability (ICC3,1 = 0.91 to 0.99, p < .001) of all gait parameters were found in a novice tester.ConclusionThe video‐based system was valid and reliable for a novice tester to measure the spatio‐temporal gait parameters in individuals with stroke.

Objective: To compare the effect of motor imagery combined with structured progressive circuit class therapy vs health education combined with structured progressive circuit class therapy on dynamic balance, endurance, and functional mobility in post-stroke individuals.Design: Randomized controlled trial.Methods: A total of 40 post-stroke individuals were randomly assigned to experimental and control groups. The experimental group was trained using motor imagery combined with structured progressive circuit class therapy, while the control group received health education combined with structured progressive circuit class therapy, for 12 sessions. Outcomes included the step test for affected and unaffected limbs, the 6-Minute Walk Test, and the Timed Up and Go test. Assessments were performed at baseline (T0), 2 weeks (T1), and 4 weeks (T2) after the intervention.Results: There were significant effects (p < 0.05) of: group on the step test for unaffected limb; of time on all outcomes; and of their interaction effect on the step test for affected limb, 6-Minute Walk Test, and Timed Up and Go test. Inter-group comparison showed significant (p < 0.05) in the step test for unaffected limb at T1. At T2, significant differences (p < 0.05) were found in the step test for affected and unaffected limbs and in the Timed Up and Go test. Conclusion: Motor imagery combined with structured progressive circuit class therapy was more effective on the step test, 6-Minute Walk Test, and Timed Up and Go test than training with structured progressive circuit class therapy alone. This suggests that motor imagery should be incorporated into training programmes for restoring dynamic balance, endurance, and functional mobility in post-stroke individuals.