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Updated: Jun 7, 2025
Author Spotlight: Rehabilitation of Stroke Patients With a Digital Occupational Training System
Published on: December 29, 2023
Cardiorespiratory exercise and self-management early after stroke to increase daily physical activity: results from a
Augustine J Devasahayam1,2, Ada Tang3, Denise Taylor4,5
1KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
Purpose:
This study aimed to determine if the Promoting Optimal Physical Exercise for Life (PROPEL) program increases participation in physical activity up to six months post-discharge from stroke rehabilitation, compared to participation in group cardiorespiratory exercise (GCE) alone.
Methods:
This was a stepped-wedge cluster superiority randomised controlled trial. People with sub-acute stroke participated in the PROPEL (n = 107) or GCE (n = 65) intervention phases. The primary outcome was adherence to physical activity guidelines over seven days at six months post-discharge from rehabilitation. Secondary outcomes were exercise self-efficacy (Short Self-Efficacy for Exercise scale), exercise-related beliefs and attitudes (Short Outcome Expectation for Exercise scale), and perceived barriers to physical activity (Barriers to Being Active Quiz).
Results:
Fifty-seven participants (PROPEL, n = 29; GCE, n = 28) were included in the analysis. At six months post-discharge, 6/17 PROPEL participants and 9/22 GCE participants met the guidelines for intensity and duration of physical activity; the odds of meeting physical activity guidelines did not differ between phases (p > 0.84). PROPEL participants reported higher self-efficacy for exercise than GCE participants (p = 0.0047).
Conclusions:
While PROPEL participants reported higher self-efficacy for exercise than those who completed GCE alone, we were unable to find evidence that this translated to increased odds of meeting physical activity guidelines.
Trial Registration:
NCT02951338IMPLICATIONS FOR REHABILITATIONIntegration of cardiorespiratory exercise with behaviour modification strategies to improve physical activity participation after discharge from stroke rehabilitation increases self-efficacy for exercise when compared to cardiorespiratory exercise alone.Increased self-efficacy for exercise may not increase the odds of meeting physical activity guidelines post-stroke.Improving self-efficacy for exercise during stroke rehabilitation may encourage participation in moderate to vigorous physical activity up to 6-months post-discharge from rehabilitation.
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