Effectiveness of a community-based low intensity exercise programme for ambulatory stroke survivors

Abstract

Purpose. To establish the feasibility and effectiveness of a community-based exercise programme for ambulatory patients with stroke discharged from rehabilitation

Method. 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 ± 5.9 to 60.4 ± 6.8 Nm after 16 exercise sessions. Walking velocity increased significantly (ANOVA, p < 0.001), from 0.54 ± 0.07 to 0.75 ± 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.

Keywords:

• Stroke
• exercise
• community-based rehabilitation

Acknowledgements

Funding support from The Stroke Association. Ms. Maggie Wyatt, University of East London; Staff of Newham and City and Hackney NHS Primary Healthcare Trusts and the Leisure Services of Newham & Hackney Borough Councils.