title: A randomized trial of two home-based exercise programmes to improve functional walking post-stroke.
abstract: OBJECTIVE
  To estimate the relative effectiveness in improving walking ability and other mobility and health outcomes post-stroke of two home-based exercise programmes - stationary cycling and an exercise and walking programme.
  
  
  METHODS
  An observer-blinded, randomized, pragmatic, trial with repeated measures.
  
  
  METHODS
  Hospital centers in two Canadian cities.
  
  
  METHODS
  People within 12 months of acute stroke who were able to walk >10 meters independently and healthy enough to engage in exercise.
  
  
  METHODS
  Two dose-equivalent interventions, one involving stationary cycling and the other disability-targeted interventions were tested. Both protocols required daily moderate intensity exercise at home building up to 30 minutes per day. One group exercised on a stationary bicycle, the second group carried out mobility exercises and brisk walking.
  
  
  METHODS
  The primary outcome was walking capacity as measured by the six-minute walk test (6MWT). Secondary outcomes were physical function, role participation, health-related quality of life exercise adherence, and adverse events.
  
  
  RESULTS
  The study failed to meet recruitment targets: 87 participants (cycle group, n = 43; exercise group, n = 44) participated. No significant effects of group or time were revealed for the 6MWT, which was approximately 320 m at randomization. A significant effect for role participation was found in favor of the exercise group (global odds ratio (OR) for cycling vs. exercise was 0.51; 95% confidence interval (CI), 0.27-0.95). Change in the 6MWT between highest and lowest adherence categories was statistically significant (p = 0.022).
  
  
  CONCLUSIONS
  Both programmes were equally effective in maintaining walking capacity after discharge from stroke rehabilitation; or were equally ineffective in improving walking capacity. Clinical Trials Gov number: NCT00786045.
authors.affiliation: McGill University, Montreal, QC, Canada. nancy.mayo@mcgill.ca
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Mayo
authors.forename: Marilyn J
authors.initials: MJ
authors.lastname: MacKay-Lyons
authors.forename: Susan C
authors.initials: SC
authors.lastname: Scott
authors.forename: Carolina
authors.initials: C
authors.lastname: Moriello
authors.forename: James
authors.initials: J
authors.lastname: Brophy
mesh_terms: D000368:Aged; D001642:Bicycling / Q000502:physiology; D002170:Canada; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006699:Home Care Services; D006801:Humans; D016014:Linear Models; D008297:Male; D051346:Mobility Limitation; D010349:Patient Compliance / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011788:Quality of Life; D017678:Sex Distribution; D018434:Sickness Impact Profile; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016138:Walking / Q000502:physiology*
keywords: Stroke; exercise; health-related quality of life; mobility; participation; rehabilitation