Exercise to enhance mobility and prevent falls after stroke: the community stroke club randomized trial

Dean, Catherine M., Rissel, Chris, Sherrington, Catherine, Sharkey, Michelle, Cumming, Robert G., Lord, Stephen R., Barker, Ruth N., Kirkham, Catherine, and O'Rourke, Sandra (2012) Exercise to enhance mobility and prevent falls after stroke: the community stroke club randomized trial. Neurorehabilitation and Neural Repair, 26 (9). pp. 1046-1057.

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Abstract

Background: Exercise interventions can enhance mobility after stroke as well as prevent falls in elderly persons. Objective. Investigate whether an exercise intervention can enhance mobility, prevent falls, and increase physical activity among community-dwelling people after stroke.

Method: A randomized trial with blinding of physical outcome assessment was conducted through local stroke clubs. Both groups, on average 5.9 years poststroke, received exercise classes, advice, and a home program for 12 months. The experimental group (EG) program (n = 76) aimed to improve walking, prevent falls and increase physical activity. The control group (CG) program (n = 75) aimed to improve upper-limb and cognitive functions. The primary outcomes were walking capacity, walking speed measured before and after the intervention, and fall rates monitored monthly.

Results: At 12 months, the EG walked 34 m further in 6 minutes (95% confidence interval [CI] = 19-50; P < .001) and 0.07 m/s faster over 10 m (95% CI = 0.01-0.14; P = .03) than the CG. The EG had 129 falls, and the CG had 133. There were no differences in proportion of fallers (relative risk = 1.22; 95% CI = 0.91-1.62; P = .19) or the rate of falls between groups (incidence rate ratio = 0.96; 95% CI = 0.59-1.51; P = .88).

Conclusion: The experimental intervention delivered through stroke clubs enhanced aspects of mobility but had no effect on falls.

Item ID: 23925
Item Type: Article (Research - C1)
ISSN: 1545-9683
Keywords: stroke, mobility limitation, accidental falls, clinical trial, exercise
Funders: NSW Health
Date Deposited: 14 Nov 2012 05:31
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1109 Neurosciences > 110904 Neurology and Neuromuscular Diseases @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110317 Physiotherapy @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920111 Nervous System and Disorders @ 34%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920409 Injury Control @ 33%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified @ 33%
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