Let’s Get Moving: A Home-Based Exercise Program for Individuals Recovering from Stroke
Over the course of the year, I have researched the effectiveness of therapeutic exercise following stroke and the benefits of implementing community-based exercise programs for chronic stroke survivors. In EBP II, I explored the literature in attempt to answer the following PICO question: For people ≤ 1-year s/p CVA, is therapeutic exercise more effective than no exercise regimen at all in reducing impairments and functional limitations associated with stroke? Here is an evidence table summarizing what I found: Evidence Table. Here is a summary of the literature in paragraph form: Summary Paper. In Health and Wellness, I developed a proposal containing a safe community-based exercise program to target strength, cardiorespiratory endurance, balance, and gait in chronic stroke survivors.
I began researching these issues because I have seen several stroke patients leave inpatient rehabilitation functioning at less than full capacity and I have wondered what else can be done for them after they go home. While hospital-based rehabilitation programs are successful in reducing stroke-related functional impairment and disability, they rarely extend beyond one-year post stroke and the resources provided by such programs are becoming increasingly limited due to rising health care costs. Therefore, I started looking into community-based exercise programs, as they have been shown to improve and retain mobility, functional capacity, and balance, as well as overall fitness. Even though these programs are effective, there is a lack of accessible and appropriate community-based exercise programs and few reports are available to guide clinical practice with regard to specific training interventions for this population.
Therefore, based on the above information, I explored the literature further and developed an exercise program that stroke survivors can easily and safely complete in their home. Home-based exercise is great for individuals who do not have access to exercise facilities or community resources or who do not have transportation to such resources. After developing the program, I worked closely with Charron Andrews, PT and Nancy Alton, ACE-certified personal trainer, who both work at the Seymour Center, to refine the program content. After the content was finalized, I led two stroke survivors through the program and developed a DVD that can be distributed to stroke survivors for home use. The video can also be viewed here: Let’s Get Moving. To accompany the video, I developed an educational handout that reviews the benefits of exercise after stroke, outlines general exercise guidelines after stroke, and offers suggestions for how to use the video. Here is the handout: Educational Handout. The DVD will primarily be distributed by Charron Andrews, PT, but if you would like a hard-copy of the DVD, then let me know!
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Thank you to all of my committee members, Charron Andrews, all video participants, and the Robert and Pearl Seymour Center for their assistance in completing this project! An evaluation form has been sent to my committee members and results will be used to improve the materials that I have created. Please let me know if you have any comments or suggestions for improvement.
Here are my personal learning objectives for this project: Objectives
Here are the references that I used to complete this project: References
7 Responses to “Home-Based Exercise for Individuals Recovering from Stroke”
Andrea Hartzell
Hi Lauren
I enjoyed reading about your project and watching your video. I also did an exercise video for the patients I treat at the Healthy Lifestyles clinic and can relate to the challenges your mentioned. You did a great job with the introduction. It was easily understood and your instructions were very clear. You did a great job picking out the activities you chose for the patients and having you and patient demonstrations will definitely help the patients at home be able to do them.
Having a home exercise is program is a great way to help people become more active at home and continue to work on improving strength, endurance, and muscle extensibility in addition to or after they receive therapy. I am sure it will be a very useful tool for many.
Great job!
blindqui
Lauren,
Great job! Reading your capstone and watching your video it made me think of how great it would be if we could personalize this type of media to each patient. In a previous rotation at a rehabilitation facility in a SNF I had access to a program that allowed me to create an exercise program with pictures and written instructions, but I think that a video format would be much more motivating and attention grabbing for many of our patients.
I commend your committee member, Charron, for considering use of your video in her practice. This could potentially lead to bigger, more advanced options that we are likely to see in the near future.
Great pace of instructions during your video as well. I imagine that if this had been more fast paced that many patients may have a hard time following, but your approach will allow access for a broad range of patients. I see myself working with the population of stroke patients when I finally get into a career and having a resource like this will be very helpful.
Thanks for all your hard work on this project!
-Brandon
lbsuggs
Carly – thanks for your comments! I did create several hard copies of the DVD that have been given to Vicki Mercer and to a few individuals at the Seymour Center for distribution. It’s best suited for their use at this point, as it is tailored for individuals who are in need of basic stretching and strengthening exercises. I don’t think it’s necessary for individuals to contact their physician prior to use due to the simplicity of the program. The video would also be distributed by a PT, who would be able to determine if the video is appropriate for the individual.
Charron – thank you for all of your help on this project. Your assistance and feedback were very valuable and it was great to work with you!
Charron Andrews
Great Job Lauren. I saw one of the “stars” the other day and he had a fun helping you out. I will definitely use the video with clients. Your instructions are very clear and meaningful.
Great job with the editing too.
Charron
Carly Laper
Lauren –
I really enjoyed your project! I did my capstone about a community based group walking program and found that a main limitation was transportation to and from the meeting site. The home based exercise is really good at working around this and people can do it whenever they have time. Also, I feel like their spouses or significant others could participate with them and it would encourage participation and motivation to complete the program.
Did you make copies to give to PT clinic or rehab hospitals to offer to their patients upon discharge? Also, do you recommend that people contact their physician before starting this program due to their increased risk of cardiovascular problems?
I really enjoyed your video and will have to use it in the future.
Carly
lbsuggs
Hi Jen,
Thanks so much for the positive feedback! It was both fun and challenging to create this video and I’m glad that you think it will be a good clinical resource. It’s meant to provide an introduction to basic exercise after stroke and can either be used alone or as an adjunct to therapy. So yes, please feel free to pass it along to patients who think might benefit from it 🙂
jtooher
Lauren,
This is SO cool!!!! What a neat idea, and one that so many people can access and use from the comfort of their homes! You talk at a really good speed and explain things well. And I love that you have some people doing the video with you!
I so often think about the problems with transportation to and from senior centers/gyms for individuals who are less mobile, especially after they are discharged from inpatient and still need therapy but don’t have the flexibility or family support. I think that home exercises that are guided and semi- self paced are a great way to bridge the gap for so many of these people, especially when safety reminders are integrated.
I’m going to be in an inpatient rehab facility for my last clinical, and I just might pass this along to some of my patients…if I can get your permission??
Such a great resource!
Jen