title: A Home- and Community-Based Physical Activity Program Can Improve the Cardiorespiratory Fitness and Walking Capacity of Stroke Survivors.
abstract: BACKGROUND
  The cardiorespiratory fitness of stroke survivors is low. Center-based exercise programs that include an aerobic component have been shown to improve poststroke cardiorespiratory fitness. This pilot study aims to determine the feasibility, safety, and preliminary efficacy of an individually tailored home- and community-based exercise program to improve cardiorespiratory fitness and walking capacity in stroke survivors.
  
  
  METHODS
  Independently ambulant, community-dwelling stroke survivors were recruited. The control (n = 10) and intervention (n = 10) groups both received usual care. In addition the intervention group undertook a 12-week, individually tailored, home- and community-based exercise program, including once-weekly telephone or e-mail support. Assessments were conducted at baseline and at 12 weeks. Feasibility was determined by retention and program participation, and safety by adverse events. Efficacy measures included change in cardiorespiratory fitness (peak oxygen consumption [VO2peak]) and distance walked during the Six-Minute Walk Test (6MWT). Analysis of covariance was used for data analysis.
  
  
  RESULTS
  All participants completed the study with no adverse events. All intervention participants reported undertaking their prescribed program. VO2peak improved more in the intervention group (1.17 ± .29 L/min to 1.35 ± .33 L/min) than the control group (1.24 ± .23 L/min to 1.24 ± .33 L/min, between-group difference = .18 L/min, 95% confidence interval [CI]: .01-.36). Distance walked improved more in the intervention group (427 ± 123 m to 494 ± 67m) compared to the control group (456 ± 101m to 470 ± 106m, between-group difference = 45 m, 95% CI: .3-90).
  
  
  CONCLUSIONS
  Our individually tailored approach with once-weekly telephone or e-mail support was feasible and effective in selected stroke survivors. The 16% greater improvement in VO2peak during the 6MWT achieved in the intervention versus control group is comparable to improvements attained in supervised, center-based programs.
authors.affiliation: School of Medicine and Public Health and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Stroke Service, Hunter New England Local Health District, New Lambton Heights, New South Wales, Australia; Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. Electronic address: Di.Marsden@hnehealth.nsw.gov.au.
authors.forename: Dianne Lesley
authors.initials: DL
authors.lastname: Marsden
authors.affiliation: School of Biomedical Sciences and Pharmacy and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia; Cardiovascular Research, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
authors.forename: Ashlee
authors.initials: A
authors.lastname: Dunn
authors.affiliation: School of Biomedical Sciences and Pharmacy and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia; Cardiovascular Research, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
authors.forename: Robin
authors.initials: R
authors.lastname: Callister
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: McElduff
authors.affiliation: Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Clinical Research & Translation and Neurology Department at John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, New South Wales, Australia; Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Callaghan, New South Wales, Australia.
authors.forename: Christopher Royce
authors.initials: CR
authors.lastname: Levi
authors.affiliation: Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; School of Biomedical Sciences and Pharmacy and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Callaghan, New South Wales, Australia; Neurology Department at John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, New South Wales, Australia.
authors.forename: Neil James
authors.initials: NJ
authors.lastname: Spratt
mesh_terms: D000328:Adult; D000368:Aged; D003153:Community Health Services; D004185:Disability Evaluation; D034742:Electronic Mail; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005240:Feasibility Studies; D005260:Female; D006304:Health Status; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010101:Oxygen Consumption; D010809:Physical Fitness; D010865:Pilot Projects; D020127:Recovery of Function; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D000071939:Stroke Rehabilitation / Q000379:methods*; D013689:Telephone; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking
keywords: Stroke; cardiorespiratory fitness; exercise; home program; walking capacity