Effectiveness of a comprehensive physical activity promotion program on physical activity levels, mobility and quality of life in community-dwelling stroke survivors: a preliminary cluster randomised controlled trial

Nayak, Pradeepa ORCID: https://orcid.org/0000-0001-8872-6858, Kumaran, Senthil D ORCID: https://orcid.org/0000-0001-6491-2584, Mahmood, Amreen ORCID: https://orcid.org/0000-0002-2803-3598, Natarajan, Manikandan ORCID: https://orcid.org/0000-0002-4329-5748, Unnikrishnan, Bhaskaran ORCID: https://orcid.org/0000-0003-0892-8551 and Solomon, John M ORCID: https://orcid.org/0000-0001-9342-1581 (2025) Effectiveness of a comprehensive physical activity promotion program on physical activity levels, mobility and quality of life in community-dwelling stroke survivors: a preliminary cluster randomised controlled trial. Disability and Rehabilitation. pp. 1-12. ISSN 0963-8288

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Abstract

Purpose To determine the effectiveness of a comprehensive Physical activity (PA) promotion program on mobility, quality of life, and PA levels among people with stroke living in the community. Methods Four community health centres were randomly allocated to the two groups. Participants in the experimental group received a comprehensive PA promotion program over a period of 45 days, whereas control group received an education session. Participants mobility was measured using 6-minute walk test (6MWT) and 10-metre walk test (10MWT), quality of life was measured using Stroke specific quality of life (SSQoL) and PA levels were measured using Physical activity scale for individuals with physical disabilities (PASIPD), Global physical activity questionnaire (GPAQ), and accelerometers. Outcome measures were assessed at baseline, one month and three months post cessation of the intervention. Results Mean age of the participants was 58.49 ± 10.01 years (n = 84). There was a group–time interaction in 6MWT [F (1, 95) = 29.723, p < 0.001, ŋ2 = 0.266], fast walking speed [F (2, 125) =19.542, p < 0.01, ŋ2 = 0.192], quality of life [(F (2, 139)=21.844, p < 0.001, ŋ2 = 0.210)], PASIPD scores [F (2, 149) =13.548, p < 0.001, ŋ2 = 0.142], GPAQ total MET mins [F (2, 143) = 13.105, p < 0.001, ŋ2 = 0.138], and steps/day [F (1, 82) = 5.195, p = 0.025, ŋ2 = 0.060]. Conclusion Comprehensive PA promotion program appears to improve mobility, quality of life and PA among community-dwelling people with stroke. IMPLICATIONS FOR REHABILITATION Comprehensive physical activity promotion program incorporating fun and engaging activities such as adaptive sports, context specific activities along with behaviour change techniques can be utilised to enhance physical activity levels of people with stroke. Comprehensive physical activity promotion program can be a model of continuum of care for people with stroke living in Low- or Middle-Income Countries where there is limited access to healthcare and leisure centres. The findings of the study suggest that a comprehensive physical activity promotion program can be implemented at the community level and allied health professionals can be trained to deliver/monitor this intervention.