Table 2.
Circuit class therapy task specific activities for the intervention
| Stations/description | Prescribed tasks |
|---|---|
| Workstation 1 | |
| Tasks for warm-up specific for upper extremity | |
| Active flexion- extension of shoulder, elbow and wrist joints | |
| Abduction-adduction of shoulder joint | |
| Upper extremity weight bearing on physiotherapy ball | |
| Push-ups on physiotherapy ball or using chair arm rest | |
| Workstation 2 | |
| Tasks for warm-up specific for lower extremity | |
| Stretching the lower extremity (flexion/extension of the limb in supine or sitting position) | |
| Marching on spot | |
| Shuttle walking | |
| Jogging on spot | |
| Workstation 3 | |
| Tasks to achieve reaching, gripping and transferring light objects | |
| Sitting with arm supported on high plinth at 90° shoulder flexion | |
| Active protraction to push small objects (light ball) off edge of plinth to target the wall | |
| Sitting same way to push weighted object (a heavier ball) | |
| Active horizontal abduction and adduction to reach object (cup) on the wall | |
| Use of protracted shoulder to open a door with patient standing three feet away from the door | |
| Wrist flexion/extension in gravity counter balance (provide a target to aim for) | |
| Radial and ulnar deviation (in gravity counter balance) with a target to push (cup) | |
| Picking light objects from table to the wall and back | |
| Workstation 4 | |
| Tasks to achieve lower extremity flexibility and function | |
| Timed shuttle walk/Initiation of minimal Shuttle jogging (50 % of time allotted for this station) | |
| Sit to stand from high chair with arm rest (placing affected leg behind the intact) | |
| Stationary bike riding | |
| Squatting activity using the wall bars | |
| Workstation 5 | |
| Task to achieve upper extremity strength/control | |
| Active shoulder flexion, extension and abduction with weight of varying sizes (dumbbells) | |
| Active shoulder flexion, extension and abduction with resistant band to reach for a target on the wall (cup) | |
| Active shoulder abduction with weights of varying sizes (dumbbells), to reach for a target on the wall | |
| Active elbow flexion/extension with resistance band. Also substitute with varying weights | |
| Active wrist flexion/extension, ulna/radial deviations with resistance band. Can be substituted later with weights of varying sizes | |
| Finger to nose movement | |
| Rapid hand alternating movements | |
| Workstation 5 | |
| Task to achieve upper extremity strength/control | |
| Active shoulder flexion, extension and abduction with weight of varying sizes (dumbbells) | |
| Active shoulder flexion, extension and abduction with resistant band to reach for a target on the wall (cup) | |
| Active shoulder abduction with weights of varying sizes (dumbbells), to reach for a target on the wall | |
| Active elbow flexion/extension with resistance band. Also substitute with varying weights | |
| Active wrist flexion/extension, ulna/radial deviations with resistance band. Can be substituted later with weights of varying sizes | |
| Finger to nose movement | |
| Rapid hand alternating movements | |
| Workstation 6 | |
| Task to achieve balance/coordination while walking | |
| Sit to stand from lower chair without arm rest (affected leg behind a distant placed intact leg) | |
| Standing on foam eye closed (safety is key in this activity) | |
| Carrying object while on shuttle walking (a tray with cup of water) | |
| Walk up and down stairs (patient walk backward while coming down stairs) | |
| Sudden stops and turns while walking | |
| Obstacle crossing while walking | |
| Figure 8 walking | |
| Workstation seven | |
| Task to achieve improved grip, precision and dexterity with upper extremity | |
| Draw a line on the white board | |
| Rolling a dumbbell forwards and backwards on a flat surface (table) | |
| Open and close a window | |
| Take lids off bottles | |
| Bring object from table to mouth, vary size and weight of objects | |
| Pour water from jug to cup | |
| Mix water with spoon of various sizes | |
| Take money in and out of a purse | |
| Fold paper and place in an envelop | |
| Trace pattern of different figures on white board | |
| Workstation 8 | |
| Task to achieve lower extremity strength/control of gait | |
| Walking different step length of parallel line | |
| Obstacle crossing while walking with a tray of cups filled with water | |
| Walking backward and side ways | |
| Heel lift in standing without and with carrying an object | |
| Walk on toes short distance forward and backward | |
| Workstation 9 | |
| Task to achieve advanced motor task with upper extremity | |
| Rolling pin pushing forward and backward | |
| Reach, grasp and move objects to and from different heights | |
| Wipe over windows | |
| Wash, wring and peg clothing on lining rope | |
| Paint sketched objects on cardboard paper | |
| Use key boards to type | |
| Cut customised foams using knifes of varying sizes | |
| Put-on common clothing and foot wears | |
| Workstation 10 | |
| Tasks to achieve improved outdoor activities with lower extremity | |
| Walking while picking objects from the floor | |
| Walking through closely packed obstacles | |
| Walking through tight space | |
| Jumping on foam eyes closed | |
| Walking on joined foams | |
| Reverse walking on straight line | |
| Treadmill walking/jogging | |
| Speed stair climbing | |
| Outdoor walking | |
| NOTE: | |
| 1. Tasks within stations are not necessarily convenient and possible for all participants, choice is therefore individualized | |
| 2. Tasks in stations vary because it is not necessary for participants to undergo all activities and also to allow room for wide range of opportunities and choices | |
| 3. Progression might be based on activities not initially possible within stations or based on modifications considered necessary by physiotherapist | |
| 4. Tasks are performed as structured in the model based on durations allotted for each group | |
Adapted from circuit class therapy intervention manual version 1.0 [56]