A community-based exercise and education scheme for stroke survivors: a randomized controlled trial and economic evaluation.
OBJECTIVE
The evaluation of a community-based exercise and education scheme for stroke survivors.


METHODS
A single blind parallel group randomized controlled trial.


METHODS
Leisure and community centres in the south-west of England.


METHODS
Stroke survivors (median (IQR) time post stroke 10.3 (5.4-17.1) months). 243 participants were randomized to standard care (124) or the intervention (119).


METHODS
Exercise and education schemes held twice weekly for eight weeks, facilitated by volunteers and qualified exercise instructors (supported by a physiotherapist), each with nine participants plus carers or family members.


METHODS
Participants were assessed by a blinded independent assessor at two weeks before the start of the scheme, nine weeks and six months. One-year follow-up was by postal assessment.


METHODS



METHODS
Subjective Index of Physical and Social Outcome (SIPSO); Frenchay Activities Index; Rivermead Mobility Index. NHS, social care and personal costs. Secondary outcomes included WHOQoL-Bref.


METHODS
Intention-to-treat basis, using non-parametric analysis to investigate change from baseline. Economic costs were compared in a cost-consequences analysis.


RESULTS
There were significant between-group changes in SIPSO physical at nine weeks (median (95% confidence interval (CI)), 1 (0, 2): P = 0.022) and at one year (0 (-1, 2): P = 0.024). (WHOQol-Bref psychological (6.2 (-0.1, 9.1): P = 0.011) at six months. Mean cost per patient was higher in the intervention group. The difference, excluding inpatient care, was pound296 (95% CI: - pound321 to pound913).


CONCLUSIONS
The community scheme for stroke survivors was a low-cost intervention successful in improving physical integration, maintained at one year, when compared with standard care.
Harrington
Rachel
R
School for Health, University of Bath, Claverton Down, Bath, UK.
Taylor
Gordon
G
Hollinghurst
Sandra
S
Reed
Mary
M
Kay
Hazel
H
Wood
Victorine A
VA
D000368:Aged; D017028:Caregivers / Q000191:economics / Q000523:psychology; D003151:Community Health Centers / Q000191:economics*; D019058:Community Networks / Q000191:economics*; D003362:Cost-Benefit Analysis; D005081:Exercise Therapy / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010353:Patient Education as Topic / Q000191:economics / Q000379:methods*; D017060:Patient Satisfaction; D011788:Quality of Life; D012944:Social Support; D013222:State Medicine / Q000191:economics; D018709:Statistics, Nonparametric; D020521:Stroke / Q000191:economics; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D006113:United Kingdom; D014838:Volunteers