A Home- and Community-Based Physical Activity Program Can Improve the Cardiorespiratory Fitness and Walking Capacity of Stroke Survivors

Dianne Lesley Marsden; Ashlee Dunn; Robin Callister; Patrick McElduff; Christopher Royce Levi; Neil James Spratt

doi:10.1016/j.jstrokecerebrovasdis.2016.06.007

A Home- and Community-Based Physical Activity Program Can Improve the Cardiorespiratory Fitness and Walking Capacity of Stroke Survivors

J Stroke Cerebrovasc Dis. 2016 Oct;25(10):2386-98. doi: 10.1016/j.jstrokecerebrovasdis.2016.06.007. Epub 2016 Jul 1.

Authors

Dianne Lesley Marsden¹, Ashlee Dunn², Robin Callister², Patrick McElduff³, Christopher Royce Levi⁴, Neil James Spratt⁵

Affiliations

¹ 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.
² 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.
³ School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.
⁴ 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.
⁵ 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.

PMID: 27378733
DOI: 10.1016/j.jstrokecerebrovasdis.2016.06.007

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.

Keywords: Stroke; cardiorespiratory fitness; exercise; home program; walking capacity.

Publication types

Controlled Clinical Trial

MeSH terms

Adult
Aged
Community Health Services*
Disability Evaluation
Electronic Mail
Exercise Test
Exercise Therapy*
Exercise Tolerance*
Feasibility Studies
Female
Health Status
Home Care Services*
Humans
Male
Middle Aged
New South Wales
Oxygen Consumption
Physical Fitness*
Pilot Projects
Recovery of Function
Stroke / diagnosis
Stroke / physiopathology
Stroke / therapy*
Stroke Rehabilitation / methods*
Telephone
Time Factors
Treatment Outcome
Walking*