Exercise in patients with subacute stroke: A randomized, controlled pilot study of home-based exercise in subacute stroke

Abstract

Background: Physical care after stroke is highly variable. The effects of therapeutic exercise on the impairments after stroke remain unclear.

Objective: To determine whether a structured, physiologically based exercise program for subacute stroke produces larger gains than those attributable to spontaneous recovery and usual care.

Methods: This randomized, controlled, single-blind pilot study was conducted in Yozgat, Turkey and enrolled 134 patients living in the community (mean age, 67 years; mean Barthel Index [BI] score, 67.4 ± 4.8) who consented to participate and were randomized from a screened sample of 765 patients. Of these, 72 patients completed the study. The intervention was a structured, progressive, physiologically based, nurse-supervised, in-home program of 24 1-h sessions over 12 weeks that targeted flexibility, strength, balance, endurance, and upper-limb function. The main outcome measures were postintervention activities of daily living (ADL) BI.

Results: The experimental group showed more improvement in ADL than the control group (BI: mean score change, 14). The BI scores in the experimental group were statistically significant (p < 0.001).

Conclusions: This study demonstrated that a pilot trial of a poststroke exercise program is feasible and is important with regard to accessibility of therapeutic exercise practice for patients at home. Improvements in the patients' neurological impairments and ADL implied the program was beneficial.

Keywords: Activities of Daily Living (ADL); exercises; nursing intervention; physical therapy; rehabilitation.