Fritz S.1, Handlery R.1, Burke A.1, Hainline G.1, Horn C.1, Keown J.1, Mcmanus A.1, Miller B.1, Purcell M.1, Liuzzo D.1, Stewart J.1
1University of South Carolina, Exercise Science / Physical Threapy Program, Columbia, United States
Background: Chronic disability can limit participation in physical activity (PA), which can be an effective tool for managing risk factors. Individuals with chronic stroke are often unable to achieve recommended levels of physical activity due to barriers unique to this population (e.g. decreased social support, self-efficacy, fear of second stroke). The NExT Gym is a community-based initiative that seeks to eliminate many of these barriers to enable and encourage survivors of stroke to participate in exercise facilitating improvements in function and quality of life.
Purpose: The purpose of this study was to determine the feasibility and effectiveness of a community-based gym for survivors of chronic stroke, and whether they continued to exercise at home after leaving the gym.
Methods: Six individuals [aged 68 (9) years] with chronic stroke [6.8 (3.7) years post stroke] participated in two sequential 9-week exercise programs with exercise intensity and exercise selection determined by the participant. Participants were free to attend or not attend as many sessions as they desired. Following completion of the second 9 week session, participants were given an individualized home exercise program (HEP), based on functional level, goals, and gym exercises. Multiple standardized assessments for mobility, balance, strength, walking, endurance, quality of life, fatigue and physical activity were performed. Assessments were performed Pre session 1, Post session 1, Pre session 2, Post Session 2 and 20 weeks post-HEP initiation.
Results: All participants completed the intervention period with an average attendance of 76% (12%) of a possible 48 sessions. There were no adverse events reported by participants during the NExT Gym. Participants demonstrated the largest improvements in from Pre 1 to Post 2 in mobility (Timed up and Go; effect size d=0.82 ), balance (Berg Balance Scale; effect size d=0.73), and fatigue (Fatigue Severity Scale; effect size d=1.14) However, only one participant reported adherence to the HEP, and declines occurred following the post HEP time (20 weeks); most notably observed in balance and fatigue. All participants who completed the entire study rated the NExT Gym as being very valuable to them, with each participant reporting a positive change in mobility (Global Rating of Change Scale).
Conclusion(s): The NExT Gym had high retention rates, high adherence rates, and positive outcomes demonstrating the benefits of exercise and physical activity for survivors of stroke. Though most participants demonstrated improved mobility, balance, and fatigue, they did not continue to exercise at home. These results demonstrate the importance of a community-based gym that is accessible for survivors of stroke on an ongoing basis; assuming that survivors of stroke will continue to exercise on their own after receiving proper direction is not supported.
Implications: The NExT Gym serves as a model for exercise programs for survivors of stroke. Promoting physical activity through an accessible gym environment is an important public health initiative to reduce health complications associated with inactivity after stroke.
Funding acknowledgements: none
Topic: Neurology: stroke
Ethics approval: University of South Carolina Institutional Review Board determined this study was exempt from review.
All authors, affiliations and abstracts have been published as submitted.
