Fit For Function: A Community Wellness Program for Persons With Stroke

Canadian Institutes of Health Research (CIHR), YMCA of Hamilton/Burlington/Brant, YMCA of Niagara, Brant Community Healthcare System, Niagara Health System, Hamilton Health Sciences Corporation

Building on an earlier pilot study, this randomized controlled trial will compare the effectiveness of a 12 week community YMCA-based wellness program specifically designed for people with stroke (Fit for Function) to a standard YMCA membership.

The program will be delivered through a partnership between McMaster University, the YMCA and Hamilton Health Sciences/ the Brant Community Healthcare System/ the Niagara Health System. Participants will exercise three times a week and receive weekly education about how to take care of themselves after a stroke. The YMCA staff who deliver the program will have specialized training about how to help people with a stroke exercise safely and effectively. The hospital within each region will provide specialized on-site physiotherapy consultative support. The comparator standard YMCA membership will include typical sessions with a wellness coach who has basic safety training regarding stroke and exercise.

A 12-week YMCA-based wellness program for persons with stroke, consisting of 2 group exercise sessions, one gym exercise session and one education session per week with trained instructors.

A 12-week YMCA-based wellness program for persons with stroke, consisting of 2 group exercise sessions, one gym exercise session and one education session per week with trained instructors

This measure assesses the degree to which individuals who have experienced traumatic or incapacitating illness achieve reintegration into normal social activities.

This is a 9-item measure that assesses frequency and intensity of aerobic physical activity and frequency of strengthening and flexibility exercises.

This test is used to quantify lower extremity function by evaluating the time to walk 8 feet, standing balance and repeated chair stands.

This is a 13-item measure of the patient's level of knowledge, skill and confidence for self-management.

The BMI will be calculated from measurements of body mass and height as an indicator of cardiovascular health.

12 hour fasting levels of inflammatory markers in blood will be used as an indicator of cardiovascular health.

An indicator of healthcare resource utilization (hospitalizations, medical appointments and investigations, medication use) for economic analysis.

Inclusion Criteria: diagnosed with stroke 18 years of age or older community dwelling able to walk 10m independently, with or without an assistive device medically approved by a physician to participate able to tolerate 60 minutes of activity with rest intervals able to independently follow instructions Exclusion Criteria: involved in an active rehabilitation program

Results will be communicated to the Central South Regional Stroke Network and the Ontario Stroke System. Results will also be disseminated through professional organizations, the Ontario Ministry of Health and Long Term Care, peer reviewed conferences, provincial and national stroke forums, journal articles and special interest groups like the Stroke Recovery Group.

Richardson J, Tang A, Guyatt G, Thabane L, Xie F, Sahlas D, Hart R, Fleck R, Hladysh G, Macrae L. FIT for FUNCTION: study protocol for a randomized controlled trial. Trials. 2018 Jan 15;19(1):39. doi: 10.1186/s13063-017-2416-3.