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Andrew S Dawson

Publications and source records attributed to Andrew S Dawson.

2 recordsLinked to original sources

A community-based group exercise program for persons with chronic stroke.

PURPOSE: The purpose of this study was to evaluate the physical and psychosocial effects of an 8-wk community-based functional exercise program in a group of individuals with chronic stroke. METHODS: Twenty-five subjects (mean age 63 yr) participated in a repeated measures design that evaluated the subjects with two baseline assessments 1 month apart, one postintervention assessment, and one retention assessment 1 month postintervention. Physical outcome measures assessed were the Berg Balance Test, 12-Minute Walk Test distance, gait speed, and stair climbing speed. Psychosocial measures assessed were the Reintegration to Normal Living Index (RNL) and Canadian Occupational Performance Measure (COPM). The 8-wk training consisted of a 60-min, 3 x wk-1 group program that focused on balance, mobility, functional strength, and functional capacity. The program was designed to be accessible by reducing the need for costly one-on-one supervision, specialized settings, and expensive equipment. RESULTS: Improvements from the exercise program were found for all physical measures and these effects were retained 1-month postintervention. Subjects with lower function improved the most relative to their initial physical status. Significant effects were found for the COPM, but not the RNL Index; however, subjects with lower RNL improved the most relative to their initial RNL Score. CONCLUSION: A short-term community-based exercise program can improve and retain mobility, functional capacity, and balance and result in a demonstrable impact upon the performance of activities and abilities that were considered meaningful to the subjects. Implementation of such community-based programs has potential for improving activity tolerance and reducing the risk for secondary complications common to stroke (e.g., falls resulting in fractures and cardiac events).

Activities of Daily Living↗

Functional walk tests in individuals with stroke: relation to perceived exertion and myocardial exertion.

BACKGROUND AND PURPOSE: Functional walk tests such as the 6- and 12-Minute Walk Test (ie, 6MWT and 12MWT, respectively) are submaximal measures used to determine functional capacity in individuals with compromised ability. The purpose of this study was to determine the relationship between these walk tests and measures of exertion (perceived and myocardial), in addition to impairment in individuals with stroke. The relationship among the 6MWT, 12MWT, and the more traditionally assessed measure of self-paced gait speed (generally assessed over a short distance, eg, 10 m) was also evaluated. METHODS: Twenty-five community-dwelling individuals with stroke were evaluated for the following: 12MWT distance, 6MWT distance, self-paced gait speed over 8 m, plantarflexion strength, Berg Balance Scale, Ashworth Scale of Spasticity, and Chedoke-McMaster Stroke Assessment. Heart rate (HR), rate-pressure product (RPP), and perceived exertion were assessed during the functional walk tests. Correlational analysis quantified the relationship between gait, impairment measures, and physiological responses during the functional walk tests. RESULTS: HR reached a steady state after 6 minutes and reflected a moderate exercise intensity of 63% of age-predicted maximum HR. The 6MWT, 12MWT, and self-paced gait speed were all highly correlated with one another (r>0.90) and were all also related to the severity of impairments. The functional walk distances did not relate either to perceived exertion or actual exertion (increase in the myocardial oxygen demand as measured by RPP). CONCLUSIONS: Stroke-specific impairments are the major limitations to the distance walked in individuals with stroke. If the functional walk test is used to assess performance of an individual over time (eg, in response to an intervention), we recommend that both exertion (eg, increase in RPP or HR) and distance be measured.

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