Promoting Optimal Physical Exercise for Life (PROPEL)

Summary

It is important for people with stroke to exercise in order to improve their overall recovery and general health. However, these individuals are less physically active than people without stroke, and they often do not achieve the recommended frequency, intensity or duration of exercise. Low levels of physical activity leads to people with stroke becoming very unfit, which can result in functional decline and increased difficulty being active. It is important to determine how to encourage people with stroke to be more active in the long-term. The transition time between the end of rehabilitation and return to the community might be an ideal time to address barriers, and to develop positive habits, knowledge and abilities for long-term participation in exercise. We developed the PROPEL program that combines exercise with self-management strategies during rehabilitation to promote physical activity after rehabilitation. Preliminary pilot findings indicate that people who completed PROPEL were more physically active after discharge than those who did not. This study aims to evaluate the effect of PROPEL on long-term participation in exercise after discharge from stroke rehabilitation.

This study will take place at 6 different hospitals. Participants will either complete a control intervention (group exercise only) or the PROPEL intervention (group exercise plus self-management). Participants’ adherence to exercise for 6 months after the end of the interventions will be evaluated using activity and heart rate monitors and physical activity questionnaires. We expect this study will show that a simple intervention delivered during rehabilitation will increase participation in exercise after rehabilitation. Increased participation in exercise could then lead to improved stroke recovery and overall health, and reduced risk of having another stroke.


Funding

Canadian Institutes of Health Research, Project Grant (2016-2019)


Trainees

Gabriela Rozanski (former post-doctoral fellow)

Jennifer Hutter (former summer student)

I am currently recruiting new trainees to work on this project


Rozanski G, Aqui A, Sivakumaran S, Mansfield A. Consumer wearable devices for activity monitoring among individuals with stroke: a prospective comparison. JMIR Cardio. 2018;2(1):e1. doi:10.2196/cardio.8199

Mansfield A, Brooks D, Tang A, Taylor D, Inness EL, Kiss A, Middleton L, Biasin L, Fleck R, French E, LeBlanc, Aqui A, Danells CJ. Promoting Optimal Physical Exercise for Life (PROPEL) – aerobic exercise and self-management early after stroke to increase daily physical activity: study protocol for a stepped-wedge randomized trial. BMJ Open 2017;7:e015843 doi:10.1136/bmjopen-2017-015843

Mansfield A, Knorr S, Poon V, Inness EL, Middleton L, Biasin L, Brunton K, Howe J-A, Brooks D. Promoting Optimal Physical Exercise for Life (PROPEL) – an exercise and self-management program to encourage participation in physical activity after discharge from stroke rehabilitation: a feasibility study. Stroke Research and Treatment. 2016;2016:9476541. doi:10.1155/2016/9476541

Brown C, Fraser JE, Inness EL, Wong JS, Middleton LE, Poon V, McIlroy WE, Mansfield A. Does participation in standardized aerobic fitness training during in-patient stroke rehabilitation promote engagement in aerobic exercise after discharge? A cohort study. Topics in Stroke Rehabilitation. 2014;21(Suppl 1):S42-51. doi:10.1310/tsr21S1-S42

Biasin L, Sage MD, Brunton K, Fraser JE, Mileris R, Howe J, Bayley M, Brooks D, McIlroy WE, Mansfield A, Inness EL. Integrating aerobic training within sub-acute stroke rehabilitation: a feasibility study. Physical Therapy. 2014;94(12):1796-1806. doi:10.2522/ptj.20130404

Papers