This project has been generously funded, by a grant from the Ontario Ministry of Health and Long-Term Care, administered and supported by the Ontario Stroke Network. The views expressed do not necessarily reflect those of the Ministry or the Ontario Stroke Network.

Authors: Mansfield A
Research: Development and preliminary evaluation of an enhanced fitness program to promote long-term engagement in physical activity after stroke
Info: Final Report Date was September 30, 2014

1. What are your main findings?

Exercise is good for everyone, including people with stroke. Previous research suggests that exercise can help speed recovery from stroke, improve overall health, and reduce the risk of having another stroke. However, many people are very inactive after they have a stroke. We implemented a new program, called PROPEL (Promoting Optimal Physical Exercise for Life) during in- and out-patient stroke rehabilitation to help people with stroke to be more active after discharge. Our preliminary findings suggest that people who completed the PROPEL program reported more physical activity after discharge and fewer barriers to exercising in the community than those who did not complete the program. Data analysis is ongoing and we hope to provide the final results soon.

2. What is new about your research?

The PROPEL program is a novel approach to improving physical activity and fitness in the community. Formal rehabilitation is only provided for a relatively short amount of time after stroke and supervised exercise programs may not be available to everyone. However, people with stroke can benefit from continued participation in exercise to promote physical fitness.  The PROPEL program, which includes both physical exercise and education components, aims to give people with stroke the knowledge, tools, and confidence they need to undertake their own exercise program after the end of the formal rehabilitation period. The program facilitators help patients to understand their own unique needs and barriers to being physically active, and to overcome these barriers.

 3. Can you explain your methodology?

The PROPEL program is part of routine care at Toronto Rehab. All people with stroke who received rehabilitation at the hospital and were considered medically safe to participate in aerobic exercise were offered the program. Patients enrolled in the PROPEL program were invited to participate in the research study. We also recruited a comparison group of individuals who completed in- and out-patient stroke rehabilitation and other hospitals and, therefore, did not complete the PROPEL program. Research participants used questionnaires and activity and heart rate monitors to record their physical activities after completion of the PROPEL program.

4. What policy recommendations do your findings suggest?

There are very few community-based exercise programs for people with stroke, and formal rehabilitation is only offered for a short amount of time after stroke. However, recovery from stroke can occur in the long-term, particularly with continued participation in exercise. These findings suggest that programs completed during the formal rehabilitation period can provide people with stroke the necessary self-management skills to continue with exercise after discharge.

5. Do your findings contradict any views or sources? If so, which ones?

To our knowledge, these findings to not contradict others.

6. How is your research meaningful for the ordinary person?

Long-term engagement in physical activity and fitness is important for everyone. After stroke, exercise can be of further benefit to improve functional ability, general health and reduce cardiovascular risk factors for recurrent stroke.  It is important that early rehabilitation not only provides patients with exercise programming, but further assists individuals to overcome unique stroke-related barriers and gain the  necessary knowledge and skills to enable their long-term involvement in exercise after formal rehabilitation.