New Research Shows Stroke Patients Benefit from Family Involvement in Exercise Therapy

Posted on: 10 March 2011

Your family’s involvement in your exercise therapy could significantly improve your function and recovery after stroke, according to new research led by a Trinity College Dublin researcher just published in the leading US journal, Stroke: Journal of the American Heart Association.

Researchers found that adding family-assisted exercise therapy to routine physical therapy after stroke improved motor function, balance, distance walked and ability to perform daily living activities.  It also lowered the strain on the family member, who said participation lowered stress and was empowering.

“It’s a win-win situation for everyone,” said Dr Emma Stokes, the study’s principal investigator and Senior Lecturer in Physiotherapy at Trinity College Dublin, “people with stroke, their families and healthcare providers share in the benefit.  Key to recovery after stroke is that the person with the stroke carries out sufficient exercise to improve their functional recovery.  Our research findings demonstrate that family members and friends can help in the delivery of the exercises and that this has positive results for both the person with stroke as well as the participating family members.”

Stroke is the most common cause of acquired major physical disability, and the third most common cause of death in Ireland.  It is estimated that 10,000 individuals are admitted to acute public hospitals annually in Ireland with stroke disease as their primary diagnosis.  Stroke accounts for 10% of total world death.

The study which was all carried out in Ireland involved 40 male and female stroke survivors.  Half received routine exercise therapy, while the others received the Family Mediated Exercise intervention (FAME) in addition to routine therapy.  The routine exercise therapy group included seven men and 13 women, average age 69. The FAME group had 13 men and seven women, average age 63.  Family members helped the stroke patient do exercises in 35-minute increments seven days per week for eight weeks to improve leg function.  The exercises were simple enough to be done at the bedside, either at the hospital or at home.  Exercise was tailored to each individual and modified weekly to reflect improvement.

Researchers assessed the outcome of the two groups after the treatment period and at three-month follow-up.  Dr Rose Galvin, FAME’s research Physical Therapist conducted brief training sessions for the participating family members and met with them on a weekly basis. 

Length of hospital stay in the family exercise group was an average 35 days compared to 40 days in the routine exercise group.  Researchers found statistically significant differences between FAME’s routine in eight measures of impairment and activity.  For example, in the six-minute walk test, the routine group walked about 47 metres more after receiving therapy, while the FAME group walked about 164 metres more compared to baseline.  Moreover, the FAME group survivors were significantly more integrated into their community at follow-up.  Family members who participated in the exercise therapy also experienced a major benefit.

“Instead of adding burden to the caregiver, participating in exercise actually enabled the family member to do something practical for their loved one in hospital,” Dr Stokes said.  “Caregivers were less stressed and more empowered.”

Co-authors on the study are: Rose Galvin, PhD; Tara Cusack, PhD University College Dublin; Eleanor O’Grady, BSC and Brendan Murphy, PhD, University College Dublin.

The research carried out in Ireland involved people with stroke who were patients in various hospitals and their families.  The hospitals were the Adelaide & Meath Hospital, Dublin incorporating the National Children’s Hospital; St James’s Hospital; Royal Hospital Donnybrook; St Vincent’s University Hospital; St Colmcille’s Hospital; Mater Misericordiae Hospital; Beaumont Hospital and Our Lady’s Hospital in Navan.

The study was funded by the Irish Heart Foundation, Medical Research Charities Group, The Friends of the Royal Hospital Donnybrook, the O’Driscoll/O’Neill bursary in conjunction with the Irish Society of Chartered Physiotherapists (2006) and the Seed Funding Scheme in University College Dublin.