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A randomized controlled trial of supervised versus unsupervised exercise programs for ambulatory stroke survivors.

Sandra J Olney·Jennifer Nymark·Brenda Brouwer·Elsie Culham·Andrew Day·Joan Heard·Margaret Henderson·Krishna Parvataneni
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Abstract

BACKGROUND AND PURPOSE: Little is known about the relative efficacy of supervised versus unsupervised community exercise programs for stroke survivors. This study compared the effectiveness of a 10-week supervised strengthening and conditioning program (supervised) with a 1-week supervised instruction program followed by a 9-week unsupervised home program (unsupervised) and evaluated retention of changes at 6 months and 1 year after program completion. METHODS: Seventy-two subjects retained at baseline (27 women, 45 men; mean+/-SD age, 64.6+/-11.8 years) were randomly allocated to receive the supervised or unsupervised program. The primary outcome was walking speed over 6 minutes, and secondary outcome measures were Human Activity Profile, Medical Outcome Study 36-Item Short-Form survey (SF-36), Physiological Cost Index, and lower extremity muscle strength. RESULTS: The 6-minute walking speed increased significantly in both groups and remained significantly improved by 1 year. The Human Activity Profile demonstrated an increasing trend only in the supervised group that was significant by 1 year. The SF-36 Physical Component summary score increased significantly in the supervised group and remained improved by 1 year; the unsupervised group showed significant improvement at 1 year. Women made greater gains in supervised programs, but men made greater gains in unsupervised programs. CONCLUSIONS: Supervised exercise programs and unsupervised programs after initial supervised instruction were both associated with physical benefits that were retained for 1 year, although supervised programs showed trends to greater improvements in self-reported gains. Gender differences require further research.

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Activities of Daily LivingAdultAgedExerciseExercise TherapyFemaleHome Care Services, Hospital-BasedHumansMaleMiddle AgedMusclesPatient ComplianceSelf CareSex FactorsStrokeStroke RehabilitationTime FactorsTreatment OutcomeWalkingJournal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov't

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Sandra J Olney, Jennifer Nymark, Brenda Brouwer, Elsie Culham, Andrew Day, Joan Heard, Margaret Henderson, Krishna Parvataneni. 2006-01-12. A randomized controlled trial of supervised versus unsupervised exercise programs for ambulatory stroke survivors.. https://doi.org/10.1161/01.str.0000199061.85897.b7

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