Effects of a Community-based Group Rehabilitation Program for Dynamic Balance and Mobility Post Stroke
Condition: Sequelae of Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      Stroke patients clearly benefit from intensive and coordinated inpatient care. While
      inpatient rehabilitation care is the preferred form for many patients post-stroke, due to
      access and financial barriers, many patients do not have this option. Community, outpatient
      rehabilitation programs will allow the patients with moderately disabling strokes the
      opportunity to maintain or augment gains achieved during inpatient stroke rehabilitation ,
      while allowing some patients with mild disability to avoid inpatient rehabilitation
      completely.

      Objective: Phase 1 randomized control trial to test the efficiency and effectiveness of
      treating adults who have suffered a single stroke using the following essential treatment
      components; a) community setting, b) group activity program, c) flexible, task-specific,
      computer-based exercise regime This program is designed to allow an extension of the
      in-patient rehabilitation experience to a community-based setting, in a cost-effective manner
      using paraprofessional staff and rehabilitation specialists, to provide a challenging,
      functional program to promote recovery and independence from physical impairments affecting
      balance and walking.

      The specific objectives are to:

        1. assess the benefits and feasibility of the multi-functional group exercise intervention
           for balance and mobility in a community setting. Secondary objectives

        2. identify effective combinations of exercises & activities that translate to increased
           abilities and participation levels.

      Hypothesis: Intense training targeting standing balance, and walking will significantly
      improve stroke clients' functional mobility. Training in a group setting and incorporating
      interactive and engaging computer gaming further provides the benefits of motivation and peer
      support while providing treatment in a cost effective manner.
    


Intervention name(s): conventional physical therapy; community-based group rehabilitation
Intervention type(s): Behavioral; Behavioral
Intervention description(s): will receive a conventional out-patient program which will include: lower extremity stretching and strengthening exercise; fitness using cycle ergometer; balance exercises in standing; over ground walking and stair exercises; Group training will include different workstations to target dynamic standing balance and walking. The key features includes facilitate repetition of task-related movements, tailored to the patient and patient's goals, in a meaningful context. Specifically:
Advanced dynamic tasks, including stepping and other transitional tasks to treadmill & over ground walking) with use of various inexpensive exercise "assistive" equipment such as mini-exercise stepper or elliptical machines.
Treadmill walking exercise program.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: community-stroke-rehabilitation,; group-exercise,; balance-mobility-exercise,; instrumented treadmill