Grant: Project Grant - PA: Circulatory and Respiratory Health

More people survive stroke now than ever before. Globally there are about 26 million stroke survivors; a statistic that is expected to double by 2038. One would think that stroke rehabilitation operates like a 'boot camp' with patients undergoing long hours of exercise and retraining in order to restore them as close to their previous level of functioning as possible. Contrary to such beliefs, most patients are sedentary, alone in their rooms with very little stimulation. In this project we will determine whether implementation of additional aerobic and strength training will improve functional independence, recovery of the limbs and central nervous system function during sub-acute inpatient stroke rehabilitation. Methods: This is an interrupted time series design trial. The first phase of our research in Year 1 involves monitoring current practices and critical stroke outcomes (150 patients per year) admitted to stroke rehabilitation. In Year 2, we will examine the impact of aerobic training then, the year after that, add strength training. The primary outcome is functional independence in physical activities (FIM). We will use structural equation modelling to "unpack the black box" and examine how therapies may work to restore function and the impacts of treatment dosage. The study represents a practical real-world test whether adding two treatments that have been previously proven to improve aspects of function (strength, walking and fitness) after stroke will improve scores on global benchmarks. The results will have important implications for other centres who are pondering such changes and for managers who are considering whether the benefits may outweigh the costs. Recovery, independence and quality of life are outcomes sought by all parties; managers, staff, patients and families. The data gathered will answer these questions but also have enormous utility for future research.