Article

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

Langue : ANGLAIS