on January 12, 2006
Published online before print January 12, 2006, doi: 10.1161/01.STR.0000199061.85897.b7
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Submitted on November 11, 2005
From the Motor Performance Group, School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada (S.J.O., B.B., E.C., M.H., K.P.); Institute for Rehabilitation Research and Development, The Rehabilitation Centre, Ottawa, Ontario, Canada (J.N., J.H.); and Clinical Research Centre, Kingston General Hospital, Kingston, Ontario, Canada (A.D.). * To whom correspondence should be addressed. E-mail: olneys{at}post.queensu.ca.
Background and Purpose--Little is known about the relative efficacy of supervised versus unsupervised community exercise programs for stroke survivors. This study compared the effectiveness of a 10-week supervised strengthening and conditioning program (supervised) with a 1-week supervised instruction program followed by a 9-week unsupervised home program (unsupervised) and evaluated retention of changes at 6 months and 1 year after program completion. Methods--Seventy-two subjects retained at baseline (27 women, 45 men; mean±SD age, 64.6±11.8 years) were randomly allocated to receive the supervised or unsupervised program. The primary outcome was walking speed over 6 minutes, and secondary outcome measures were Human Activity Profile, Medical Outcome Study 36-Item Short-Form survey (SF-36), Physiological Cost Index, and lower extremity muscle strength. Results--The 6-minute walking speed increased significantly in both groups and remained significantly improved by 1 year. The Human Activity Profile demonstrated an increasing trend only in the supervised group that was significant by 1 year. The SF-36 Physical Component summary score increased significantly in the supervised group and remained improved by 1 year; the unsupervised group showed significant improvement at 1 year. Women made greater gains in supervised programs, but men made greater gains in unsupervised programs. Conclusions--Supervised exercise programs and unsupervised programs after initial supervised instruction were both associated with physical benefits that were retained for 1 year, although supervised programs showed trends to greater improvements in self-reported gains. Gender differences require further research.
Accepted on November 22, 2005
A Randomized Controlled Trial of Supervised Versus Unsupervised Exercise Programs for Ambulatory Stroke Survivors
Sandra J. Olney PhD*;
Key words: cerebrovascular accident • exercise • rehabilitation
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