A new program developed by University of Alberta researchers is showing promise in helping stroke survivors stride towards recovery after leaving hospital.
A pilot study confirmed that the intervention, known as BIG STEPS, could safely and practically help people sit less and move more after returning home following hospitalization for a stroke - a "whole-of-the-day" approach that is important for long-term health and wellness, says lead author Dr. Victor Ezeugwu of the Faculty of Rehabilitation Medicine.
"Stroke survivors may not stay physically active enough on their own after leaving hospital, and that means they could be missing out on vital health benefits, such as lowering their risk of having another stroke," he notes.
The 12-week BIG STEPS program, adapted from earlier U of A research exploring the effect of a home-based 'sit less, move more' program after stroke, consists of behavioural coaching with structured goal progression to increase daily steps and reduce sedentary time.
"Recovery continues for months after stroke happens, but many people become much less active once their structured rehabilitation ends, so BIG STEPS was designed to support them during this transition by combining coaching from a physical therapist with individual walking goals and wearable sensors for self-monitoring," Ezeugwu says.
Early, high-intensity walking has proven important as part of stroke rehabilitation, he adds, noting that the walking goals of BIG STEPS increase gradually over time as confidence and ability improve.
"The coaching helps people with their expectations, goal-setting and navigating everyday barriers such as fatigue, fear of falling, bad weather or simply finding ways to balance daily routines." The activity sensors - commercial smartwatches - provide immediate feedback so participants can see their progress, while therapists can safely adjust goals based on objective information.
Over 17 months, the study tracked 28 adults who'd had a stroke within the preceding three months and were transitioning back to home life. The participants, who had an average age of 68, were split into two equal groups. The first began the BIG STEPS program right away, and the second group delayed their start for 12 weeks. Both groups continued to receive standard post-stroke medical care and rehabilitation, including mobility, balance and strengthening exercises provided through physical therapy.
