Adaptive Physical Activity for Stroke: An Early-Stage Randomized Controlled Trial in the United States.
Citation: Neurorehabilitation & Neural Repair. 33(8):668-680, 2019 08.PMID: 31296113Institution: MedStar National Rehabilitation NetworkForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Exercise Therapy | *Stroke/th [Therapy] | Aged | Community Health Services | Exercise Therapy/ec [Economics] | Exercise Therapy/mt [Methods] | Feasibility Studies | Female | Humans | Male | Middle Aged | Paresis/et [Etiology] | Paresis/pp [Physiopathology] | Paresis/th [Therapy] | Single-Blind Method | Stroke/co [Complications] | Stroke/pp [Physiopathology] | Treatment Outcome | United StatesYear: 2019Local holdings: Available online from MWHC library: 2006 - 2009, Available in print through MWHC library: 1999 - March 2006ISSN:- 1545-9683
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 31296113 | Available | 31296113 |
Available online from MWHC library: 2006 - 2009, Available in print through MWHC library: 1999 - March 2006
Background. As stroke survival improves, there is an increasing need for effective, low-cost programs to reduce deconditioning and improve mobility. Objective. To conduct a phase II trial examining whether the community-based Italian Adaptive Physical Activity exercise program for stroke survivors (APA-Stroke) is safe, effective, and feasible in the United States. Methods. In this single-blind, randomized controlled trial, 76 stroke survivors with mild to moderate hemiparesis >6 months were randomized to either APA-Stroke (N = 43) or Sittercise (N = 33). APA-Stroke is a progressive group exercise regimen tailored to hemiparesis that includes walking, strength, and balance training. Sittercise, a seated, nonprogressive aerobic upper body general exercise program, served as the control. Both interventions were 1 hour, 3 times weekly, in 5 community locations, supervised by exercise instructors. Results. A total of 76 participants aged 63.9 +/- 1.2 years, mean months poststroke 61.8 +/- 9.3, were included. There were no serious adverse events; completion rates were 58% for APA-Stroke, 70% for Sittercise. APA-Stroke participants improved significantly in walking speed. Sample size was inadequate to demonstrate significant between-group differences. Financial and logistical feasibility of the program has been demonstrated. Ongoing APA classes have been offered to >200 participants in county Senior Centers since study completion. Conclusion. APA-Stroke shows great promise as a low-cost, feasible intervention. It significantly increased walking speed. Safety and feasibility in the US context are demonstrated. A pivotal clinical trial is required to determine whether APA-Stroke should be considered standard of care.
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