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Published on: October 11, 2024
Power Exercise for Stroke Recovery: The POWER Feasibility Trial
Kenneth S Noguchi1, Juliano A Abreu, Zoe M Sanvido
1School of Rehabilitation Science (K.S.N., M.K.B., L.T., A.T.); Department of Kinesiology (J.A.A., Z.M.S., S.M.P., K.E.B.); Physical Activity Centre of Excellence, McMaster University (P.B., A.M., S.M.P.); Community Partner (B.E.); Department of Health Research Methods, Evidence and Impact, McMaster University (L.T.); Biostatistics Unit, St Joseph's Healthcare-Hamilton, Hamilton, Ontario, Canada (L.T.); and Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa (L.T.).
Background And Purpose:
Strength training is recommended after stroke to retain strength and function. Muscle power is important for mobility, presenting an opportunity for power training programs. The objectives of this study were to (1) determine the feasibility and (2) effects of the power exercise for stroke recovery (POWER) intervention in people with mild to moderate chronic stroke.
Methods:
This was a single-group trial in people with mild to moderate chronic stroke (modified Rankin Scale < 4). The POWER intervention was delivered in a community-based gym over 3 phases: familiarization (week 1), strength (weeks 2-5), and power (weeks 6-10), where repetitions were performed as quickly as possible. Feasibility was the primary outcome, measured using preestablished indicators. Effects were measured with the timed up and go test, short physical performance battery, 30-second chair stand test, fast-paced walking speed, isokinetic strength, power, and the stroke impact scale.
Results:
Fifteen people (61.5 years, 4.9 years poststroke, n = 7 female) were recruited within 6 months. Attendance was high (96%), with minimal attrition (n = 1) and no serious adverse events or exaggerated blood pressure responses to exercise. Most (71%) exercise sets were adhered to. There were improvements in timed up and go performance (-1.6 seconds [95% confidence interval, CI: -0.6, -2.6]), short physical performance battery (+0.9, 95% CI: 0.1, 1.8), fast-paced walking (+0.1 m/s, 95% CI: 0.01, 0.2), and the 30-second chair stand test (+3.0, 95% CI: 1.7, 4.2). There were also moderate to large improvements in muscle strength, power, and health-related quality of life.
Discussion And Conclusions:
POWER was feasible and shows potential effects on muscle strength, power, physical function, and health-related quality of life in community-dwelling people with mild to moderate chronic stroke.