Extended, progressive physical therapy aids stroke survivors mobility

DALLAS, Aug. 15 Stroke survivors who received therapist-supervised, progressive therapy after completing in-hospital rehabilitation significantly improved their endurance, balance and walking ability, according to a small study reported in today's rapid access issue of Stroke: Journal of the American Heart Association.

This study goes beyond the commonly held therapy paradigm that stroke patients achieve their most dramatic recovery within the first 30 days after stroke, says lead author Pamela W. Duncan, Ph.D., a physical therapist professor at the University of Florida, Gainesville, Fla.

"We demonstrated that by providing a home-based exercise program that's much more aggressive than what is typically prescribed, stroke survivors can improve their walking ability, balance and cardiovascular endurance," says Duncan, who is also director of the Brooks Center for Rehabilitation Studies, and director of the Department of the Veterans Affairs Rehab Outcomes Research Center in Gainesville.

The study is the first to incorporate multiple components strength, balance, endurance and upper extremity function into a comprehensive stroke recovery program, she says. Stroke is the leading cause of disability in older Americans, and falls are a major problem for stroke survivors, according to Duncan.

"After hospital discharge, stroke survivors continue to improve," she says. "But available therapy is highly variable. Additional therapy often lasts only a few weeks and lacks progression in intensity and task complexity. We investigated the effect of structured, progressive intervention on recovery."

Researchers studied 92 stroke survivors (average age 70) from the Kansas City Stroke Registry one to four months after their stroke. Each had mild to moderate stroke deficits and had completed in-hospital rehabilitation. All survivors underwent tests for motor function, strength, balance and endurance at the start of the study. Participants were

Contact: Carole Bullock
American Heart Association

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