Rehabilitation care after stroke is highly variable and increasingly shorter in duration.Stroke patients can improve their endurance, balance and mobility if they participate in a structured exercise programme after completing in-hospital rehabilitation, new research suggests. Researchers from the University of Florida Health Science Centre, USA, examined whether a structured, therapist-supervised exercise programme for stroke is more beneficial than usual care. One hundred patients were included in the study and 92 completed the trial. The exercise programme included 36 sessions over a 12-week period that targeted flexibility, strength, balance, endurance, and upper-extremity function. It was found that both groups experienced improvements in strength, balance, upper- and lower-extremity motor control, upper-extremity function, and walking speed. However, the exercise group 'achieved greater gains than the usual care group in measures of endurance, balance, 6-minute walk distance,' and walking speed. Given the degree of constraint on stroke rehabilitation services in the current healthcare environment, the researchers conclude that evidence of gains from intensive therapy has substantial implications for future service planning.

Stroke, Sept 2003