The feasibility and efficacy of an augmented exercise program for acute stroke patients

Abstract

BACKGROUND AND AIMS: Augmenting exercise time has been shown to hasten stroke recovery, but its effect on mobility recovery during the very acute phase has been understudied. METHODS: We performed a randomized double-blinded controlled trial in a 16-bed acute stroke unit in HK. Thirty-nine (21 male, 18 female) stroke patients with mild mobility limitation, were recruited within one-week of onset and randomized to augmented therapy group (ATG) or control group (CG). Subjects from both groups received additional exercise sessions for three days. Exercise program for ATG was based on task-oriented strength training of the lower limb while those for the CG contained dexterity exercises within arm-reach. Outcome measures included Modified functional ambulation classification (MFAC), Modified Rivermead mobility index (MRMI), Functional reach (FR), Five times sit to stand (FTSTS), Step test, Berg Balance Scale (BBS), Timed up and go test and Gait speed (comfortable and maximum) were performed at recruitment and after intervention. Patients’ compliances and any adverse event were recorded. RESULTS: A total of 32 patients (mean age = 66.34 +/- 11.54) completed the study with initial and post-therapy assessments. A series of 2 x 2 analysis of variance with repeated measures (group x time) were done to investigate the change of our main outcome measures. There were statistically significant improvements in all mobility outcome measures post-therapy (Ps< 0.01), but no between groups difference or interaction effect was evident. CONCLUSIONS: Augmenting exercise time to people with mild stroke during the acute phase appears to be safe to carry out. A lack of measurable difference between groups may be due to small subject size or insufficient intervention.