Grant: CIHR Fellowship

Stroke is an important health issue in adults as many have problems with activities such as walking. This leads to less physical activity and higher risk for heart disease and future strokes. Research shows that exercise can increase fitness and walking after stroke, but we do not know how much exercise is best. The key aim of this study is to see if slightly harder exercise leads to better fitness and walking ability after stroke, lowers risk for having another stroke (such as lower blood pressure and cholesterol levels), and leads to more activity at home and in the community. Volunteers with stroke who are listed with the Vancouver General Hospital will have their fitness level and walking ability assessed, and blood tests done to measure their cholesterol and blood sugar levels. Small devices worn around the ankles will measure how much walking and exercise they perform at home. Questionnaires will be completed to see how the stroke has affected their life. All volunteers are then randomly assigned to 1 of 3 groups: the first group exercises at a higher heart rate, the second group at a lower heart rate and the third group will participate in stretching and education sessions. After 6 months, the volunteers are assessed again for changes in their fitness, walking ability, blood tests and responses on the questionnaires. The ankle devices will be used to see if they walk and exercise more. These devices give us an idea of any "real-world" changes they may make and have not been used before to look at the effects of exercise after stroke. We will assess them one more time, 3 months after the program has ended, to see if there are any more changes. The findings from this study can have long-term benefits to people with stroke and will help the health professionals who work with them understand the best way to promote a healthy lifestyle to lower risk for heart disease or another stroke.