A community-based exercise and education scheme for stroke survivors: a randomized controlled trial and economic evaluation

Abstract

The community scheme for stroke survivors was a low-cost intervention successful in improving physical integration, maintained at one year, when compared with standard care.

Group Circuit Class Therapy for Stroke Survivors – A Review of the Evidence and Clinical Implications

“…While group therapy can be used for a variety of aims, including improving speech and language (Simmons-Mackie & Elman 2011) or providing education (Mudge et al, 2009;Harrington et al, 2010;Marsden et al, 2010), this chapter is devoted to the concept of using circuit class therapy for improving motor function. This can include motor function of the arm or leg; however the majority of research to date has focused on outcomes relating to leg function, such as standing balance and walking.…”

“…The staff to patient ratio ranged from 1:1 to up to seven participants per therapist (Mead et al, 2007). With the exception of two trials (Harrington et al, 2010;Marsden et al, 2010), participants in all trials were able to walk independently at enrolment. All trials indicated that group circuit class therapy was being provided with the intent to improve walking ability, although additional aims including balance, community reintegration and arm function were mentioned in some of the trials.…”

“…None of the included studies reported on these sorts of costs. Although not completely comparable, the study of (Harrington et al, 2010) included an economic evaluation when studying the effects of a community-based exercise and education scheme for stroke survivors (Harrington et al, 2010). They concluded that the costs were significantly higher in the intervention group compared to the control group receiving usual care.…”

“…Most tasks from the published studies were focussed on the leg, but studying the effects of arm tasks would be helpful to further improve arm rehabilitation. More research into the effects of educational or behavioural components would be beneficial to build on the positive results reported by Harrington et al (2010) and Marsden et al (2010) particularly in regard to reducing lifestyle stroke risk factors and increasing activity levels, both in the hospital setting and in the community. And while stroke recovery guidelines and research studies suggest that therapy should be given with a high intensity, the exact optimal doseresponse relationship remains unclear and needs further study.…”

Editorial: Physical fitness training after stroke: time to translate evidence into practice

“…When we scoped the provision of services in Scotland, transport for participants to and from the service was cited as an important barrier, as well as the cost to service providers, although trial evidence indicates that costs can be low. 12 Stroke survivors, healthcare professionals and those who commission new services may not be fully aware of the benefits of exercise after stroke. There may, in some areas, be a lack of suitably qualified exercise professionals, although this is changing with the UK rollout of the Exercise and Fitness Training after Stroke course.…”