title: Exercise intervention to prevent falls and enhance mobility in community dwellers after stroke: a protocol for a randomised controlled trial.
abstract: BACKGROUND
  Stroke is the most common disabling neurological condition in adults. Falls and poor mobility are major contributors to stroke-related disability. Falls are more frequent and more likely to result in injury among stroke survivors than among the general older population. Currently there is good evidence that exercise can enhance mobility after stroke, yet ongoing exercise programs for general community-based stroke survivors are not routinely available. This randomised controlled trial will investigate whether exercise can reduce fall rates and increase mobility and physical activity levels in stroke survivors.
  
  
  METHODS
  Three hundred and fifty community dwelling stroke survivors will be recruited. Participants will have no medical contradictions to exercise and be cognitively and physically able to complete the assessments and exercise program. After the completion of the pre-test assessment, participants will be randomly allocated to one of two intervention groups. Both intervention groups will participate in weekly group-based exercises and a home program for twelve months. In the lower limb intervention group, individualised programs of weight-bearing balance and strengthening exercises will be prescribed. The upper limb/cognition group will receive exercises aimed at management and improvement of function of the affected upper limb and cognition carried out in the seated position. The primary outcome measures will be falls (measured with 12 month calendars) and mobility. Secondary outcome measures will be risk of falling, physical activity levels, community participation, quality of life, health service utilisation, upper limb function and cognition.
  
  
  CONCLUSIONS
  This study aims to establish and evaluate community-based sustainable exercise programs for stroke survivors. We will determine the effects of the exercise programs in preventing falls and enhancing mobility among people following stroke. This program, if found to be effective, has the potential to be implemented within existing community services.
  
  
  BACKGROUND
  The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12606000479505).
authors.affiliation: Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia. C.Dean@usyd.edu.au
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Dean
authors.forename: Chris
authors.initials: C
authors.lastname: Rissel
authors.forename: Michelle
authors.initials: M
authors.lastname: Sharkey
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
authors.forename: Ruth N
authors.initials: RN
authors.lastname: Barker
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: Sandra D
authors.initials: SD
authors.lastname: O'Rourke
authors.forename: Catherine
authors.initials: C
authors.lastname: Kirkham
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D000071939:Stroke Rehabilitation; D016138:Walking