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F. Nindorera1,2, I. Nduwimana1,2, J.L. Thonnard2, Y. Bleyenheuft2, O. Kossi3,4,2
1National Center of Reference in Physiotherapy and Medical Rehabilitation (CNRKR), University Hospital of Kamenge, Bujumbura, Burundi, 2Institute of Neuroscience, Catholic University of Louvain, Brussels, Belgium, 3Unit of Rehabilitation, University Hospital of Parakou, Parakou, Benin, 4National School of Public Health and Epidemiology, University of Parakou, Parakou, Benin
Background: Post-stroke disability leads victims to physical inactivity, which is explained by several factors related to the stroke. Although several types of physical activity (treadmill, robot assisted training, balance training, resistance training…) have been shown to be effective for the functioning of stroke survivors, their modalities of achievement were trial dependent and require equipment that is sometimes too expensive. To our knowledge, the effect of a combination of more than 2 types of physical activity, performed in a group and in a structured and fun way has not yet been highlighted.
Purpose: This study aims to investigate the effects of CBCS training on impairments, activity limitation and social participation in people with chronic stroke.
Methods: A randomized controlled trial, with blinded assessments, was performed by forty-six community-dwelling chronic stroke individuals (time since stroke ≥ 6 months). Participants were randomly assigned to either the experimental group (n = 23, CBCS trainings) or the control group (n = 23, passive socio-cultural activities: social games, theatre,). Both groups performed 120-min training sessions, three times per week over 12 weeks, in groups of five to eight participants, with a trained physiotherapist. The primary outcome was activity limitation (ACTIVLIM-Stroke). Secondary outcomes were balance (Berg Balance scale), manual ability (Abilhand scale), impairments (Stroke impairments Assessment Set), endurance (6MWT) and social participation (PM-Scale). The effects of the CBCS training was analyzed from the collected data using intention to treat. Between and within group differences were measured by independent and repeated t test measures respectively, considering the baseline and post-training. Similarity between groups was checked before intervention.
Results: Our sample’s mean ± SD age was 50.50 ± 10.8 years (Female=10; Male=36). Training specific effects were observed; the experimental group improved both outcomes: activity limitation (ACTIVLIM-Stroke p<0.001); balance (BBS, p<0.001); manual ability (Abilhand, p<0.001); impairments (SIAS, p<0.001); endurance when walking (6MWT distance, p<0.001) and social participation (PM-Scale p<0.001). Both groups improved participation (PM scale, CG, p<0.001) and manual ability (Abilhand CG, p<0.001).
Conclusion(s): Collective and combined physical activity (CBCS) improves the ICF components but socio-cultural activities seem to be effective in improving participation and manual ability. CBCS can improve the functional autonomy of stroke survivors in the chronic phase when they are done in a structured and fun way.
Implications: This indicates a possible clinical relevance of these training modalities. CBCS should form part of a comprehensive health promotion strategy to be used in rehabilitation.
Funding, acknowledgements: Acknowledgement to ‘Wallonie-Bruxelles International (WBI)’ and ‘Association pour la Promotion de l'Education et de la Formation à l’Etranger (APEFE)’
Keywords: Stroke, combined training and physical activity, activity limitation and participation
Topic: Neurology: stroke
Did this work require ethics approval? Yes
Institution: Institut National de Sante Publique
Committee: Comite National d'Ethique
Ethics number: CNE/25/2019
All authors, affiliations and abstracts have been published as submitted.
