title: Exercise to enhance mobility and prevent falls after stroke: the community stroke club randomized trial.
abstract: BACKGROUND
  Exercise interventions can enhance mobility after stroke as well as prevent falls in elderly persons.
  
  
  OBJECTIVE
  Investigate whether an exercise intervention can enhance mobility, prevent falls, and increase physical activity among community-dwelling people after stroke.
  
  
  METHODS
  A randomized trial with blinding of physical outcome assessment was conducted through local stroke clubs. Both groups, on average 5.9 years poststroke, received exercise classes, advice, and a home program for 12 months. The experimental group (EG) program (n = 76) aimed to improve walking, prevent falls and increase physical activity. The control group (CG) program (n = 75) aimed to improve upper-limb and cognitive functions. The primary outcomes were walking capacity, walking speed measured before and after the intervention, and fall rates monitored monthly.
  
  
  RESULTS
  At 12 months, the EG walked 34 m further in 6 minutes (95% confidence interval [CI] = 19-50; P < .001) and 0.07 m/s faster over 10 m (95% CI = 0.01-0.14; P = .03) than the CG. The EG had 129 falls, and the CG had 133. There were no differences in proportion of fallers (relative risk = 1.22; 95% CI = 0.91-1.62; P = .19) or the rate of falls between groups (incidence rate ratio = 0.96; 95% CI = 0.59-1.51; P = .88).
  
  
  CONCLUSIONS
  The experimental intervention delivered through stroke clubs enhanced aspects of mobility but had no effect on falls.
authors.affiliation: Macquarie University, North Ryde, Australia. catherine.dean@mq.edu.au
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Dean
authors.forename: Chris
authors.initials: C
authors.lastname: Rissel
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.forename: Michelle
authors.initials: M
authors.lastname: Sharkey
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: Ruth N
authors.initials: RN
authors.lastname: Barker
authors.forename: Catherine
authors.initials: C
authors.lastname: Kirkham
authors.forename: Sandra
authors.initials: S
authors.lastname: O'Rourke
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010349:Patient Compliance; D011446:Prospective Studies; D011788:Quality of Life; D018401:Sample Size; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology