A Home- and Community-Based Physical Activity Program Can Improve the Cardiorespiratory Fitness and Walking Capacity of Stroke Survivors

Background: The cardiorespiratory fitness of stroke survivors is low. Center-based exercise programs that include an aerobic component have been shown to improve poststroke cardiorespiratory fitness. This pilot study aims to determine the feasibility, safety, and preliminary efficacy of an individually tailored home-and community-based exercise program to improve cardiorespiratory fitness and walking capacity in stroke survivors. Methods: Independently ambulant, community-dwelling stroke survivors were recruited. The control (n = 10) and intervention (n = 10) groups both received usual care. In addition the intervention group undertook a 12-week, individually tailored, home-and community-based exercise program, including once-weekly telephone or e-mail support. Assessments were conducted at baseline and at 12 weeks. Feasibility was determined by retention and program participation, and safety by adverse events. Efficacy measures included change in cardiorespiratory fitness (peak oxygen consumption [VO2peak]) and distance walked during the Six-Minute Walk Test (6MWT). Analysis of covariance was used for data analysis. Results: All participants completed the study with no adverse events. All intervention participants reported undertaking their prescribed program. VO2peak improved more in the intervention group (1.17 +/- .29 L/min to 1.35 +/-.33 L/min) than the control group (1.24 +/-.23 L/min to 1.24 +/-.33 L/min, between-group difference =.18 L/min, 95% confidence interval [CI]:.01-. 36). Distance walked improved more in the intervention group (427 +/- 123 m to 494 +/- 67m) compared to the control group (456 +/- 101m to 470 +/- 106m, between-group difference = 45 m, 95% CI:.3-90). Conclusions: Our individually tailored approach with once-weekly telephone or e-mail support was feasible and effective in selected stroke survivors. The 16% greater improvement in VO(2)peak during the 6MWT achieved in the intervention versus control group is comparable to improvements attained in supervised, center-based programs.