Online neuropilates exercise classes for post stroke patients: A randomised feasibility study

Stroke survivors are often sedentary, with known barriers to exercise including physical disabilities and transport issues. One innovative way to overcome barriers is to provide group exercise programmes via videoconferencing. Neuropilates, a programme of modified Pilates underpinned by neurological rehabilitation principles, may have benefits for stroke survivors but is under-researched. The aim of the study is to examine the feasibility and safety of an online neuropilates programme in stroke survivors.

The design was a single-blinded randomised feasibility study with participants randomly allocated to one of three groups. The intervention group partook in a 6-week, once weekly, online, live neuropilates exercise class. Control Group 1 (CG1) partook in a 6-week, online, live general exercise class and control group 2 (CG2) were given an unsupervised home exercise programme (HEP). Primary feasibility outcomes were assessed. Gait speed, balance, balance confidence, functional strength, tone and quality of life were also assessed. A cost analysis was undertaken to understand resource utilisation implications.

Twelve participants were enrolled to the study. The online neuropilates programme was well tolerated and accepted. There were no adverse events related to the exercise classes. The intervention was practical and conducted with ease apart from the issue of reduced visibility of the entire participants' bodies on screen. The intervention group improved all clinical scores on average after the intervention except tone which increased slightly. CG1 experienced improvements in most outcomes except gait speed and tone. CG2 also experienced marginal within group improvements, except for functional lower limb strength. Most, but not all improvements were maintained at 3-month follow-up assessments across all groups. Costs per minute of patient contact were €0.44 in the intervention group, €0.33 in control group 1 and €0.65 in control group 2 over the trial period.

Overall, an online neuropilates programme was sufficiently feasible, practical and safe. Based on these findings, a large-scale trial is warranted to definitively test an online neuropilates programme in the post stroke population with the use of multiple centres to improve recruitment.