TY  - BOOK
AU  - Dromerick, Alexander W
TI  - Adaptive Physical Activity for Stroke: An Early-Stage Randomized Controlled Trial in the United States
SN  - 1545-9683
PY  - 2019///
KW  - *Exercise Therapy
KW  - *Stroke/th [Therapy]
KW  - Aged
KW  - Community Health Services
KW  - Exercise Therapy/ec [Economics]
KW  - Exercise Therapy/mt [Methods]
KW  - Feasibility Studies
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Paresis/et [Etiology]
KW  - Paresis/pp [Physiopathology]
KW  - Paresis/th [Therapy]
KW  - Single-Blind Method
KW  - Stroke/co [Complications]
KW  - Stroke/pp [Physiopathology]
KW  - Treatment Outcome
KW  - United States
KW  - MedStar National Rehabilitation Network
KW  - Journal Article
N1  - Available online from MWHC library: 2006 - 2009, Available in print through MWHC library: 1999 - March 2006
N2  - 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
UR  - https://dx.doi.org/10.1177/1545968319862562
ER  -