title: Stroke: a randomized trial of exercise or relaxation.
abstract: OBJECTIVE
  To determine the feasibility and effect of exercise training after stroke.
  
  
  METHODS
  Randomized exploratory trial comparing exercise training (including progressive endurance and resistance training) with relaxation (attention control).
  
  
  METHODS
  Interventions were performed in a rehabilitation hospital.
  
  
  METHODS
  Sixty-six independently ambulatory patients (mean age 72, 36 men) without significant dysphasia, confusion, or medical contraindications to exercise training who had completed their usual rehabilitation and had been discharged from hospital.
  
  
  METHODS
  Both interventions were held three times a week for 12 weeks. Up to seven patients attended each session.
  
  
  METHODS
  The Functional Independence Measure; Nottingham Extended Activities of Daily Living; Rivermead Mobility Index; functional reach; sit-to-stand; elderly mobility score; timed up-and-go; Medical Outcomes Study 36-Item Short Form Questionnaire, version 2 (SF-36); Hospital Anxiety and Depression Score; aspects of physical fitness (comfortable walking speed, walking economy, and explosive leg extensor power) were measured at baseline, immediately after interventions (3 months), and 7 months after baseline.
  
  
  RESULTS
  The median number of intervention sessions attended was 36 (interquartile range (IQR) 30.00-36.75) for exercise and 36 (IQR 30.50-37.00) for relaxation. Adherence to the individual exercises ranged from 94% to 99%. At 3 months, role-physical (an item in SF-36), timed up-and-go, and walking economy were significantly better in the exercise group (analysis of covariance). At 7 months, role-physical was the only significant difference between groups.
  
  
  CONCLUSIONS
  Exercise training for ambulatory stroke patients was feasible and led to significantly greater benefits in aspects of physical function and perceived effect of physical health on daily life.
authors.affiliation: Department of Geriatric Medicine, University of Edinburgh, Edinburgh, UK. gillian.e.mead@ed.ac.uk
authors.forename: Gillian E
authors.initials: GE
authors.lastname: Mead
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Greig
authors.forename: Irene
authors.initials: I
authors.lastname: Cunningham
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Lewis
authors.forename: Susie
authors.initials: S
authors.lastname: Dinan
authors.forename: David H
authors.initials: DH
authors.lastname: Saunders
authors.forename: Claire
authors.initials: C
authors.lastname: Fitzsimons
authors.forename: Archie
authors.initials: A
authors.lastname: Young
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D010349:Patient Compliance; D020127:Recovery of Function / Q000502:physiology; D020521:Stroke / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome