Abstract
OBJECTIVE:

The evaluation of a community-based exercise and education scheme for stroke survivors.
DESIGN:

A single blind parallel group randomized controlled trial.
SETTING:

Leisure and community centres in the south-west of England.
SUBJECTS:

Stroke survivors (median (IQR) time post stroke 10.3 (5.4-17.1) months). 243 participants were randomized to standard care (124) or the intervention (119).
INTERVENTION:

Exercise and education schemes held twice weekly for eight weeks, facilitated by volunteers and qualified exercise instructors (supported by a physiotherapist), each with nine participants plus carers or family members.
METHOD:

Participants were assessed by a blinded independent assessor at two weeks before the start of the scheme, nine weeks and six months. One-year follow-up was by postal assessment.
MAIN MEASURES:

PRIMARY OUTCOMES:

Subjective Index of Physical and Social Outcome (SIPSO); Frenchay Activities Index; Rivermead Mobility Index. NHS, social care and personal costs. Secondary outcomes included WHOQoL-Bref.
ANALYSIS:

Intention-to-treat basis, using non-parametric analysis to investigate change from baseline. Economic costs were compared in a cost-consequences analysis.
RESULTS:

There were significant between-group changes in SIPSO physical at nine weeks (median (95% confidence interval (CI)), 1 (0, 2): P = 0.022) and at one year (0 (-1, 2): P = 0.024). (WHOQol-Bref psychological (6.2 (-0.1, 9.1): P = 0.011) at six months. Mean cost per patient was higher in the intervention group. The difference, excluding inpatient care, was pound296 (95% CI: – pound321 to pound913).
CONCLUSION:

The community scheme for stroke survivors was a low-cost intervention successful in improving physical integration, maintained at one year, when compared with standard care.