An Exercise Prescription for Patients with Stroke and Sarcopenia Based on the Modified Delphi Study

Area of Science:

• Neurology
• Gerontology
• Physical Therapy

Background:

• Sarcopenia, a common condition in stroke survivors with hemiplegia, significantly impacts recovery and quality of life.
• There is a need to establish evidence-based exercise interventions tailored for this specific patient population.

Purpose of the Study:

• To achieve expert consensus on the necessity and prioritization of exercise interventions for preexisting sarcopenia in hemiplegic stroke patients.
• To develop standardized recommendations for exercise prescription in this clinical context.

Main Methods:

• A modified three-round Delphi study involving expert panelists.
• Responses were collected using a 7-point Likert scale, with consensus defined as >75% agreement.
• Statistical analysis included descriptive statistics, percentage of strong agreement, and Kendall's coefficient of concordance.

Main Results:

• Consensus was reached on 53 of 58 items in the first round and all items in subsequent rounds.
• The need for exercise intervention was strongly supported by the panelists.
• High levels of agreement were observed for most items, indicating robust consensus.

Conclusions:

• This Delphi study provides the first expert consensus on exercise for sarcopenia in hemiplegic stroke.
• Standardized recommendations include 57 priorities, with 49 considered strong recommendations.
• Excluded items highlight considerations for patients with balance deficits, cognitive impairment, or mental vulnerability.