Background: Post-stroke disability leads victims to physical inactivity, which is explained by several factors related to the stroke. These factors have been identified as the causes and consequences of functional declines and health problems. Therefore, it is important to increase community physical activity levels and reduce the time spent in low-energy expenditure activities after a stroke. Although several types of physical activity (treadmill, robot assisted training, balance training, resistance training…) have been shown to be effective for the functioning of stroke survivors, their modalities of achievement were trial dependent and require equipment that is sometimes too expensive. To our knowledge, the effect of a combination of more than 2 types of physical activity, performed in a group and in a structured and fun way has not yet been highlighted. It may be important to investigate whether collective physical activity “Circuit walking, balance, cycling and strengthening trainings” (CBCS) is effective in improving activity and participation.

Objective: This study aims to investigate the effects of CBCS training on impairments, activity limitation and social participation in people with chronic stroke.

Methods/design: A randomized controlled trial, with blinded assessments, will be performed in a community based setting. Altogether, 50 adults chronic stroke patients (>6 months) will be included. Participants will be randomly assigned to either: (1) CBCS training (experimental group; combined and collective physical activity) or (2) sociocultural activities with more interaction (control group, social games, theatre). Both groups will attend 120-min training sessions, three times per week over 12 weeks, in groups of five to eight participants, with a trained physiotherapist. Primary outcome is activity limitation (Activilim stroke scale). Secondary outcomes are balance (Berg Balance scale and Timed Up and Go test), manual ability (Abilhand scale and Box and block test), impairments (Stroke impairments Assessment Set) endurance (6MWT) and speed (10mWT), depression, and quality of life. The effects of the CBCS training will be analyzed from the collected data using intention to treat. Between-group differences will be measured by two-way repeated measures ANOVA, considering the baseline, post-training, and 12-week follow-up.

Conclusion: The results of this trial will likely provide valuable new information on the effects of combined, structured and collective training on the ICF components “Impairments, activity limitation and participation”, through changes in activity and participation scores.

Keywords: Stroke, combined trainings, Physical activity, activity limitation, participation