✓ 100% Success Exercise for stroke survivors in a community setting Camden active health team The original research study: Starter Trial (Mead 2007) Stroke: A Randomised Trial of Exercise or Relaxation. Initiate a lifestyle change in individuals at risk of developing cardiovascular disease (CVD), using a physical activity and behaviour change intervention. • 66 independently mobile stroke survivors (with and without walking aids) • Randomly selected to take part in an exercise group or a relaxation group • Three times a week for 12 weeks. • Tests were done at the start and end of the 12 weeks • Transport was provided for patients. Tests to measure success • The Timed Up And Go (TUAG) : The patient is timed to see how long it takes them to get up from a chair, walk three metres around a cone and sit back down again. • The 10 metre walk: The time it takes for a patient to walk 10 metres. Results After 12 weeks the TUAG and the 10 m walk improvement was higher in the exercise group than the relaxation group. Conclusion The independently mobile stroke survivors saw benefits both physically, (can do more without feeling tired) and quality of life (realising they can do more). Is it possible to add a specialist Exercise and Fitness after Stroke class into an existing GP referral programme? Could we run a weekly Stroke Rehab community class (no transport provided) based on the Starter trial and still make a difference? What we did ….. Class • Once a week for one hour in a community hospital gym • The class contained a warm/up; - movements to raise body temperature and loosen joints • Exercises for stamina/endurance, to do more for longer; - stationary bike (legs) - lifting and lowering a ball (shoulders) - sitting down and standing up (legs) - a step (legs) - press ups against the wall (arms) - exercises for balance • Exercises to improve strength; - these were sitting down and standing up- slowly (legs), - exercises to strengthen the back of your arms (triceps) - picking up a pole and putting it back down without dropping it (biceps) - back strengthening (back) • Finishing exercises to cool the body down and stretch the muscles. What happened… Everyone that took part made an improvement. • Average attendance nine sessions out of 12 • Average for 10m walk 19% • Average for Timed Up and Go 26% Gender Age %TUAG change %10m change a. M 82 + 16 + 21 b. M 52 + 37 + 34 c. M 36 + 53 + 13 d. F 80 + 13 + 2 e. M 65 + 10 + 23 What we wanted to find out? Our results show that all participants made significant improvements and suggest that targeted Exercise following a Stroke should be an integral part of a referral programme. All participants that took part made significant improvements in both TUAG and 10m walk. One participant improved his TUAG by over 50% -he is able to now walk faster without his walking stick than he did before the trial with his walking stick). What we found out in the end 0 10 20 30 40 50 60 a b c d e % increase Parcipants %TUAG change %10m change

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✓ 100% SuccessExercise for stroke survivors in a community setting Camden active health team

The original research study: Starter Trial (Mead 2007)

Stroke: A Randomised Trial of Exercise or Relaxation. Initiate a lifestyle change in individuals at risk of developing cardiovascular disease (CVD), using a physical activity and behaviour change intervention.

• 66 independently mobile stroke survivors (with and without walking aids)

• Randomly selected to take part in an exercise group or a relaxation group

• Three times a week for 12 weeks.

• Tests were done at the start and end of the 12 weeks

• Transport was provided for patients.

Tests to measure success • The Timed Up And Go (TUAG) : The patient is timed to see

how long it takes them to get up from a chair, walk three metres around a cone and sit back down again.

• The 10 metre walk: The time it takes for a patient to walk

10 metres.

Results After 12 weeks the TUAG and the 10 m walk improvement was higher in the exercise group than the relaxation group.

Conclusion The independently mobile stroke survivors saw benefits both physically, (can do more without feeling tired) and quality of life (realising they can do more).

Is it possible to add a specialist Exercise and Fitness after Stroke class into an existing GP referral programme? Could we run a weekly Stroke Rehab community class (no transport provided) based on the Starter trial and still make a difference?

What we did ….. Class • Once a week for one hour in a community hospital gym• The class contained a warm/up; - movements to raise body temperature and loosen joints

• Exercises for stamina/endurance, to do more for longer;- stationary bike (legs)- lifting and lowering a ball (shoulders)- sitting down and standing up (legs) - a step (legs)- press ups against the wall (arms)- exercises for balance

• Exercises to improve strength;- these were sitting down and standing up- slowly (legs), - exercises to strengthen the back of your arms (triceps)- picking up a pole and putting it back down without dropping it (biceps)- back strengthening (back)

• Finishing exercises to cool the body down and stretch the muscles.

What happened… Everyone that took part made an improvement.

• Average attendance nine sessions out of 12

• Average for 10m walk 19%

• Average for Timed Up and Go 26%

Gender Age %TUAG change %10m change

a. M 82 + 16 + 21

b. M 52 + 37 + 34

c. M 36 + 53 + 13

d. F 80 + 13 + 2

e. M 65 + 10 + 23

What we wanted to find out?

Our results show that all participants made significant improvements and suggest that targeted Exercise following a Stroke should be an integral part of a referral programme.

All participants that took part made significant improvements in both TUAG and 10m walk. One participant improved his TUAG by over 50% -he is able to now walk faster without his walking stick than he did before the trial with his walking stick).

What we found out in the end 0

a b c d e

% increase

Participants

%TUAG change %10m change