Mixed-methods study investigating the efficacy and acceptance of a seated exercise program delivered virtually to improve mobility in older adults living with stroke

BACKGROUND: Stroke is common with a 1 in 4 lifetime risk of stroke after age 25. One of the most sought after goals by people with stroke is improved mobility. Since the COVID-19 pandemic, many hospital programs reduced their capacity while community programs for stroke remain closed. There has been an enormous increase of physical therapists supervising exercise programs in the homes of patients over the internet despite little supporting evidence. People with stroke have substantial physical impairments, and falls can easily occur when balance is challenged. We are proposing a unique seated exercise program that will be safe to deliver over the internet and will improve mobility after stroke. PURPOSE: This will be the first study to evaluate the effect of a seated exercise program delivered by videoconference over the internet to improve mobility after a stroke. In addition, we will explore the acceptance of the program through interviews. METHODS: Older adults who have lived with a stroke more than 12 months and have mobility problems will be assigned to a Seated Exercise Group or a Memory Training Group. Both will be delivered by videoconference over 36 sessions in 12 weeks. Both groups will be measured at 3 time points (baseline), after the treatment (12 weeks later) and follow-up (12 weeks after program ends). We will compare the improvements between the Seated Exercise Group and Control Group on outcomes including mobility, balance, blood pressure and quality of life. We will also examine the costs of the program. We will also interview participants, caregivers and therapists on their experiences with the Seated Exercise Program. SIGNIFICANCE: The Seated Exercise Program delivered through the internet has the potential to provide a safe home treatment to improve mobility for people living with stroke. This program can reach people in more rural locations, eliminate transportation needs and prevent the risk of spreading COVID-19.