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Open Access Highly Accessed Study protocol

Exercise intervention to prevent falls and enhance mobility in community dwellers after stroke: a protocol for a randomised controlled trial

Catherine M Dean1*, Chris Rissel23, Michelle Sharkey4, Catherine Sherrington5, Robert G Cumming36, Ruth N Barker7, Stephen R Lord8, Sandra D O'Rourke1 and Catherine Kirkham14

Author Affiliations

1 Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia

2 Health Promotion Service, Sydney South West Area Health Service, Level 9 (North), King George V Missenden Road, Camperdown, NSW 2050, Australia

3 School of Public Health, The University of Sydney, Sydney, Australia

4 Stroke Recovery Association NSW, PO Box 3401, Putney, NSW 2112, Australia

5 Musculoskeletal Division, The George Institute for International Health, The University of Sydney, PO Box M201, Missenden Rd, Sydney, NSW 2050, Australia

6 Centre for Education and Research on Ageing, Concord Hospital, Sydney, Australia

7 School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, QLD 4811, Australia

8 Prince of Wales Medical Research Institute, The University of New South Wales, PO Box 82, St Pauls, NSW 2031, Australia

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BMC Neurology 2009, 9:38  doi:10.1186/1471-2377-9-38

Published: 22 July 2009

Abstract

Background

Stroke is the most common disabling neurological condition in adults. Falls and poor mobility are major contributors to stroke-related disability. Falls are more frequent and more likely to result in injury among stroke survivors than among the general older population. Currently there is good evidence that exercise can enhance mobility after stroke, yet ongoing exercise programs for general community-based stroke survivors are not routinely available. This randomised controlled trial will investigate whether exercise can reduce fall rates and increase mobility and physical activity levels in stroke survivors.

Methods and design

Three hundred and fifty community dwelling stroke survivors will be recruited. Participants will have no medical contradictions to exercise and be cognitively and physically able to complete the assessments and exercise program. After the completion of the pre-test assessment, participants will be randomly allocated to one of two intervention groups. Both intervention groups will participate in weekly group-based exercises and a home program for twelve months. In the lower limb intervention group, individualised programs of weight-bearing balance and strengthening exercises will be prescribed. The upper limb/cognition group will receive exercises aimed at management and improvement of function of the affected upper limb and cognition carried out in the seated position. The primary outcome measures will be falls (measured with 12 month calendars) and mobility. Secondary outcome measures will be risk of falling, physical activity levels, community participation, quality of life, health service utilisation, upper limb function and cognition.

Discussion

This study aims to establish and evaluate community-based sustainable exercise programs for stroke survivors. We will determine the effects of the exercise programs in preventing falls and enhancing mobility among people following stroke. This program, if found to be effective, has the potential to be implemented within existing community services.

Trial registration

The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12606000479505).