A Randomized Controlled Trial of Supervised Versus Unsupervised Exercise Programs for Ambulatory Stroke Survivors

Abstract

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; meanϮSD age, 64.6Ϯ11.8 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. (Stroke. 2006;37:476-481.)

The Long-term Effects of Progressive Resistance Training on Health-related Quality in Older Adults

“…More positive findings in the TR group may reflect social aspects of going out and the associated positive environment. Olney and colleagues (Olney et al, 2006) report that supervision or inclusion in a social group may play a supportive role. The home program may not have met participants' needs for social contact or for a sense of belonging (Helbostad et al, 2004).…”

Elaboração de um manual ilustrado de exercícios domiciliares para pacientes com hemiparesia secundária ao acidente vascular encefálico (AVE)

“…Duncan et al 20 implantaram um programa de exercícios domiciliares três vezes por semana, durante oito semanas, em pacientes de AVE leve e moderado, observando melhora funcional de membros inferiores. Já Olney et al 21 compararam um programa de exercícios supervisionados com não supervisionados (apenas com uma instrução prévia) e observaram benefícios físicos imediatos e após um ano em ambos os programas. Outro estudo, em 2009, observou se um programa de exercícios domiciliares melhora a força, o desempenho físico e a capacidade funcional de pacientes com AVE crônico 22 .…”

Fatores de risco associados a quedas em idosas: um enfoque preventivo

“…Em um estudo envolvendo 171 idosas japonesas, acometidas por Acidentes Vasculares Encefálicos (AVEs), com idade de 65 anos, divididas aleatoriamente em grupo intervenção e grupo controle, em que foram avaliados os efeitos agudos do exercício sobre a função física e o risco de quedas, foi constatado que não houve melhora significativa sobre o risco de quedas determinado pela Escala de Eficácia em Quedas (FES) em ambos os grupos, mas registrou-se significativa evolução na força dos extensores do joelho, com significância igual a 0,040 (OLNEY et al, 2006).…”