Article

The evaluation of a community-based exercise and education scheme for
stroke survivors. DESIGN:
A single blind parallel group randomized controlled
trial. SETTING: Leisure and community centres in the south-west of
England.Subjects: Stroke survivors (median (IQR) time post stroke 10.3 (5.4-17.1)
months). 243 participants were randomized to standard care (124) or the
intervention (119). INTERVENTION: Exercise and education schemes held twice
weekly for eight weeks, facilitated by volunteers and qualified exercise
instructors (supported by a physiotherapist), each with nine participants plus
carers or family members. METHOD: Participants were assessed by a blinded
independent assessor at two weeks before the start of the scheme, nine weeks and
six months. One-year follow-up was by postal assessment. MAIN MEASURES: Primary
outcomes: Subjective Index of Physical and Social Outcome (SIPSO); Frenchay
Activities Index; Rivermead Mobility Index. NHS, social care and personal costs.
Secondary outcomes included WHOQoL-Bref. ANALYSIS: Intention-to-treat basis,
using non-parametric analysis to investigate change from baseline. Economic costs
were compared in a cost-consequences analysis. RESULTS: There were significant
between-group changes in SIPSO physical at nine weeks (median (95% confidence
interval (CI)), 1 (0, 2): P = 0.022) and at one year (0 (-1, 2): P = 0.024).
(WHOQol-Bref psychological (6.2 (-0.1, 9.1): P = 0.011) at six months. Mean cost
per patient was higher in the intervention group. The difference, excluding
inpatient care, was pound296 (95% CI: - pound321 to pound913). CONCLUSION: The
community scheme for stroke survivors was a low-cost intervention successful in
improving physical integration, maintained at one year, when compared with
standard care.

Langue : ANGLAIS