A Community-Based Upper-Extremity Group Exercise Program Improves Motor Function and Performance of Functional Activities in Chronic Stroke: A Randomized Controlled Trial

Pang MY, Harris JE, Eng JJ. A community-based upper-extremity group exercise program improves motor function and performance of functional activities in chronic stroke: a randomized controlled trial.ObjectiveTo assess the effects of a community-based exercise program on motor recovery and functional abilities of the paretic upper extremity in persons with chronic stroke.DesignRandomized controlled trial.SettingRehabilitation research laboratory and a community hall.ParticipantsA sample of 63 people (≥50y) with chronic deficits resulting from stroke (onset ≥1y).InterventionsThe arm group underwent an exercise program designed to improve upper-extremity function (1h/session, 3 sessions/wk for 19wk). The leg group underwent a lower-extremity exercise program.Main Outcome MeasuresThe Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment (FMA), hand-held dynamometry (grip strength), and the Motor Activity Log.ResultsMultivariate analysis showed a significant group by time interaction (Wilks λ=.726, P=.017), indicating that overall, the arm group had significantly more improvement than the leg group. Post hoc analysis demonstrated that gains in WMFT (functional ability) (P=.001) and FMA (P=.001) scores were significantly higher in the arm group. The amount of improvement was comparable to other novel treatment approaches such as constraint-induced movement therapy or robot-aided exercise training previously reported in chronic stroke. Participants with moderate arm impairment benefited more from the program.ConclusionsThe pilot study showed that a community-based exercise program can improve upper-extremity function in persons with chronic stroke. This outcome justifies a larger clinical trial to further assess efficacy and cost effectiveness.