Adaptive Physical Activity for Stroke: An Early-Stage Randomized Controlled Trial in the United States. 

 -  2019 
<br/><br/>Available online from MWHC library: 2006 - 2009, Available in print through MWHC library: 1999 - March 2006 
<br/><br/> 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. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>1545-9683 
<br/><br/><label>Standard No.: </label>10.1177/1545968319862562 [doi] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Exercise Therapy<br/>*Stroke/th [Therapy]<br/>Aged<br/>Community Health Services<br/>Exercise Therapy/ec [Economics]<br/>Exercise Therapy/mt [Methods]<br/>Feasibility Studies<br/>Female<br/>Humans<br/>Male<br/>Middle Aged<br/>Paresis/et [Etiology]<br/>Paresis/pp [Physiopathology]<br/>Paresis/th [Therapy]<br/>Single-Blind Method<br/>Stroke/co [Complications]<br/>Stroke/pp [Physiopathology]<br/>Treatment Outcome<br/>United States
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar National Rehabilitation Network
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article