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Adaptive Physical Activity for Stroke: An Early-Stage Randomized Controlled Trial in the United States
Mary Stuart1,2,3, Alexander W Dromerick4,5,6, Richard Macko2,3
11 University of Maryland Baltimore County, Baltimore, MD, USA.
Neurorehabilitation and Neural Repair
|July 13, 2019
Summary
The Adaptive Physical Activity for Stroke (APA-Stroke) program shows promise as a safe and feasible exercise intervention for stroke survivors in the US, significantly improving walking speed. Further trials are needed to establish it as standard care.
Area of Science:
- Rehabilitation Medicine
- Exercise Science
- Public Health
Background:
- Rising stroke survival rates necessitate effective, affordable rehabilitation programs.
- Post-stroke deconditioning and mobility impairments require targeted interventions.
- The study addresses the need for accessible physical activity programs for stroke survivors.
Purpose of the Study:
- To evaluate the safety, efficacy, and feasibility of the Italian Adaptive Physical Activity for Stroke (APA-Stroke) program in the United States.
- To adapt and test a community-based exercise program for stroke survivors with hemiparesis.
- To determine the potential of APA-Stroke as a scalable rehabilitation solution.
Main Methods:
- A single-blind, randomized controlled trial involving 76 stroke survivors with mild to moderate hemiparesis.
- Participants were randomized to either the progressive APA-Stroke group exercise or a seated Sittercise control group.
- Interventions were conducted in community settings over 1 hour, 3 times weekly, supervised by instructors.
Main Results:
- No serious adverse events were reported during the trial.
- The APA-Stroke group demonstrated significant improvements in walking speed.
- While completion rates varied (58% APA-Stroke, 70% Sittercise), the program proved financially and logistically feasible.
- The study was underpowered to detect significant between-group differences in all outcomes.
Conclusions:
- APA-Stroke is a safe, feasible, and promising low-cost intervention for stroke survivors in the US.
- The program significantly enhances walking speed, a key indicator of mobility.
- Demonstrated feasibility supports its expansion into community senior centers.
- A larger pivotal trial is recommended to ascertain APA-Stroke's role in standard stroke care.
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