Home and Community Care Digest
Methods: Participants were recruited from a local rehabilitation hospital, community stroke clubs, and local advertisements. A total of 63 older individuals with chronic stroke met the selection criteria (e.g., aged ≥ 50, chronic stroke sustained one or more years previously, physically able to ride a bike) participated in the study. Participants were randomly assigned to an intervention (n=32) or control group (n=31). The intervention group underwent a fitness and mobility exercise (FAME) program designed to improve cardiorespiratory fitness, mobility, leg muscle strength, balance, and hip bone mineral density. The control group underwent a seated upper extremity program without aerobic exercise, leg strengthening or balance training. The intervention and control programs took place in a room in a community hall, and consisted of 1-hour sessions, three times per week, for 19 weeks. A physical therapist, an occupational therapist, and an exercise instructor coordinated and supervised the sessions.
Findings: At the end of the study, participants who received the FAME program showed significant improvement in cardiorespiratory fitness, mobility, and stroke-affected leg muscle strength when compared to those receiving only the upper extremity rehabilitation program. This study provides the first evidence that regular exercise is beneficial for hipbone health in chronic stroke population. Femoral neck bone mineral density was maintained in the intervention group, whereas a 2.5% decline occurred in the control group.
Conclusions: Study results suggest that the FAME program has the potential to improve some of the secondary health complications resulting from physical inactivity in older adults living with chronic stroke. Individuals suffering from chronic stroke showed significant improvement in cardiorespiratory fitness, mobility, and stroke-affected leg muscle strength, and maintained hipbone mineral density compared to the control group. While this study demonstrates the efficacy of the FAME communitybased fitness program for older individuals with chronic stroke, decision makers will be interested in whether the FAME program is a cost-effective use of resources compared to traditional rehabilitation and exercise programs for these populations. Unfortunately, this study does not provide evidence pertaining to the cost of the intervention, so conclusions about the cost-effectiveness await further research.
Reference: Pang MYC, Eng JJ, Dawson AS, McKay HA, JE Harris. "A Community-based Fitness and Mobility Exercise Program for Older Adults with Chronic Stroke: A Randomized Controlled Trial". Journal of American Geriatrics Society, 2005; 53: 1667-1674
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