IMproving Physical ACtivity after stroke via Treadmill training (IMPACT) and self-management: A randomized trial

Area of Science:

• Neurology
• Rehabilitation Medicine
• Exercise Physiology

Background:

• Stroke survivors often experience reduced physical activity post-rehabilitation, impacting long-term recovery.
• Enhancing physical activity is crucial for improving functional outcomes and quality of life after stroke.

Purpose of the Study:

• To evaluate the effectiveness of treadmill training integrated with self-management education on physical activity levels in stroke survivors during inpatient rehabilitation.
• To compare this intervention against usual gait training.

Main Methods:

• A randomized trial involving 119 independent-walking stroke survivors compared 8 weeks of treadmill training (40-60% heart rate reserve) plus self-management education to usual gait training.
• Outcomes, including steps/day, walking ability, and cardiorespiratory fitness, were assessed at baseline, 8 weeks, and 26 weeks.

Main Results:

• The experimental group averaged 1436 more steps/day after 8 weeks compared to the control group (95% CI: 229 to 2643).
• This increase in physical activity was largely maintained at 6 months, with 871 more steps/day (95% CI: -385 to 2129).
• No significant differences were observed in other secondary outcomes between the groups.

Conclusions:

• Treadmill training embedded in self-management education significantly increases physical activity in stroke survivors during inpatient rehabilitation.
• The observed increase in physical activity is largely sustained at 6 months post-intervention.
• The self-management component is suggested to be responsible for the sustained increase in physical activity, as improvements in walking or cardiorespiratory fitness were minimal.