Article

Objective: To estimate the relative effectiveness in improving walking ability
and other mobility and health outcomes post-stroke of two home-based exercise
programmes - stationary cycling and an exercise and walking programme. Design: An
observer-blinded, randomized, pragmatic, trial with repeated measures. Setting:
Hospital centers in two Canadian cities. Subjects: People within 12 months of
acute stroke who were able to walk >10 meters independently and healthy enough to
engage in exercise. Interventions: Two dose-equivalent interventions, one
involving stationary cycling and the other disability-targeted interventions were
tested. Both protocols required daily moderate intensity exercise at home
building up to 30 minutes per day. One group exercised on a stationary bicycle,
the second group carried out mobility exercises and brisk walking. Main measures:
The primary outcome was walking capacity as measured by the six-minute walk test
(6MWT). Secondary outcomes were physical function, role participation,
health-related quality of life exercise adherence, and adverse events. Results:
The study failed to meet recruitment targets: 87 participants (cycle group, n =
43; exercise group, n = 44) participated. No significant effects of group or time
were revealed for the 6MWT, which was approximately 320 m at randomization. A
significant effect for role participation was found in favor of the exercise
group (global odds ratio (OR)
for cycling vs. exercise was 0.51; 95% confidence
interval (CI), 0.27-0.95). Change in the 6MWT between highest and lowest
adherence categories was statistically significant (p = 0.022). Conclusions: Both
programmes were equally effective in maintaining walking capacity after discharge
from stroke rehabilitation; or were equally ineffective in improving walking
capacity. Clinical Trials Gov number: NCT00786045.

Langue : ANGLAIS