Effectiveness of a community-based low intensity exercise programme for ambulatory stroke survivors.
OBJECTIVE
To establish the feasibility and effectiveness of a community-based exercise programme for ambulatory patients with stroke discharged from rehabilitation.


METHODS
Eighteen participants were recruited 3-12 months after onset of first stroke. Using a time series experimental design, the group completed a baseline period of 4 weeks (A1), a group exercise programme of low-intensity progressive resistive exercise and functional tasks for lower limb muscles (B) and repeat assessment after cessation of exercise (A2). Fitness instructors delivered sessions at Leisure Centres twice weekly for 14 weeks with physiotherapy support and the minimum attendance requirement was 16 sessions. Measures included muscle strength, gait velocity, Berg Balance Scale and Nottingham Extended Activities of Daily Living.


RESULTS
Lower limb muscle strength improved after training (ANOVA, p < 0.02). Paretic knee extension strength increased from 43.4 + or - 5.9 to 60.4 + or - 6.8 Nm after 16 exercise sessions. Walking velocity increased significantly (ANOVA, p < 0.001), from 0.54 + or - 0.07 to 0.75 + or - 0.08 m/s (t = -3.31, p < 0.01). Balance and everyday function were also significantly improved (p < 0.003). There were marked individual variation in the response to training, and those who completed additional training did not show benefit.


CONCLUSIONS
This community-based exercise programme was feasible and delivered positive improvements in physical function for participants. Further issues raised for investigation include the individual response to training and the benefits of extended training.
Cramp
Mary Christine
MC
University of East London, School of Health and Bioscience, Romford Road, Stratford, London E15 4LZ, UK. m.c.cramp@uel.ac.uk
Greenwood
Richard J
RJ
Gill
Michael
M
Lehmann
Anthea
A
Rothwell
John Christine
JC
Scott
Oona M
OM
D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration*; D000704:Analysis of Variance; D003153:Community Health Services / Q000458:organization & administration*; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology