Video-guided exercise after stroke: a feasibility randomised controlled trial

ABSTRACT

Background

Facilitating self-directed upper-limb exercise in people after a stroke whilst not in therapy sessions may increase therapy intensity and improve outcomes. Objectives: To investigate the feasibility and acceptability of video-guided exercise for facilitating upper-limb exercise after stroke.

Methods

A single-blind feasibility randomized controlled trial with embedded qualitative study in stroke wards at a large teaching hospital in the United Kingdom. Fourteen participants with stroke were randomized to either video-guided exercise intervention or a “treatment-as-usual” control group. Intervention participants received a computer tablet containing filmed individualized exercises to guide out of therapy practice. The primary outcome measure was the Motor status scale (MSS) for the upper limb, which was used to guide possible sample sizes for a future main trial. Qualitative focus group and interview data on feasibility/acceptability were collected and analyzed.

Results

The intervention was acceptable, but the need for motivation/support to exercise was highlighted. Based on similar assumptions to the feasibility study, circa ninety-two patients in each group would be needed to detect a difference of 5 in upper-limb motor status for a main trial.

Conclusion

A trial of video-guided exercise is feasible, although an optimal main trial would require some relatively minor changes to design, outcome measures, eligibility, and the intervention.

KEYWORDS:

• Pilot clinical trial
• stroke
• physiotherapy
• mobile tablet
• self-directed exercise

Acknowledgments

Madeleine Kenny is funded by a National Institute for Health Research (NIHR) Masters in Clinical Research Award for this research project. This publication presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care.

Declarations of interest

The authors report no conflicts of interest.