Logo for the Journal of Rehab R&D
Volume 45 Number 2, 2008
Pages 323 — 328

Abstract - Adaptive physical activity improves mobility function and quality of life in chronic hemiparesis

Richard F. Macko, MD;1-3 Francesco Benvenuti, MD;4* Steven Stanhope, PhD;5 Velio Macellari, DrEng;6 Antonia Taviani, MD;4 Barbara Nesi, PT;4 Michael Weinrich, MD;7 Mary Stuart, ScD1,8

1Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs (VA) Maryland Health Care System, Baltimore VA Medical Center (VAMC) Baltimore, MD; 2VA Rehabilitation Research and Development Exercise and Robotics Center of Excellence, Baltimore VAMC, Baltimore, MD; 3Departments of Neurology and Medicine, Division of Gerontology, University of Maryland School of Medicine, Baltimore, MD; 4Dipartimento della Riabilitazione, Azienda Unità Sanitaria Locale 11, Regione Toscana, Empoli, Italy; 5National Institutes of Health (NIH), Physical Disabilities Branch, Bethesda, MD; 6Reparto Biomeccanica e Tecnologie Riabilitative, Dipartimento Tecnologie e Salute, Istituto Superiore di Sanità, Roma, Italy; 7NIH, National Institute of Child Health and Human Development, Bethesda, MD; 8Departments of Sociology and Anthropology, University of Maryland, Baltimore County, Baltimore, MD

Abstract — This study investigated the effects of an adaptive physical activity (APA) program on mobility function and quality of life (QOL) in chronic stroke patients. Twenty subjects with chronic hemiparesis completed a 2-month, combined group, class-home exercise regimen that emphasized mobility training. APA improved Berg Balance Scale scores (35 +/- 2 vs 45 +/- 2, p = 0.001), 6-minute walk distances (114 +/- 15 vs 142 +/- 7 m, p < 0.001), and Short Physical Performance Battery scores (3.2 +/- 0.4 vs 5.2 +/- 0.6, p < 0.001). Barthel Index scores increased (75 +/- 4 vs 84 +/- 4, p < 0.001), but Lawton scores were unchanged. Geriatric Depression Scale (p < 0.01) and Stroke Impact Scale (SIS), Mobility, Participation, and Recovery improved with APA (p < 0.03). APA has the potential to improve gait, balance, and basic but not instrumental activities of daily living profiles in individuals with chronic stroke. Improved depression and SIS scores suggest APA improves stroke-specific outcomes related to QOL.

Key words: activities of daily living, adaptive physical activity, exercise, group exercise, hemiplegia, home exercise regimen, mobility, quality of life, rehabilitation, stroke.


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