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Does a cycling program combined with education and followed by coaching promote physical activity in subacute stroke patients? A randomized controlled trial [with consumer summary]
Vanroy C, Vanlandewijck Y, Cras P, Truijen S, Vissers D, Swinnen A, Bosmans M, Wouters K, Feys H
Disability and Rehabilitation 2019;41(4):413-421
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: To investigate the effects of a three month active cycling program followed by coaching on physical activity in subacute stroke patients. METHODS: Patients (n = 59; mean age 65.4 +/- 10.3) aged <= 80 years with first stroke and able to cycle at 50 revolutions/minute enrolled 3 to 10 weeks post stroke. Patients were randomly allocated to three month active cycling group (n = 33) or to a control group (n = 26), 3x30 minutes training/week. Afterwards, the active cycling group was randomized into a coaching (n = 15) versus non-coaching group (n = 16) for nine months. Physical activity was measured by objective and self-reported measures, which were taken before/after the active cycling program and during six and 12 months, except the Baecke-questionnaire, which was used at baseline and 12 months. RESULTS: A significant difference was found in Baecke/sport (95% confidence interval 0.06 to 2.24; p = 0.039) between the active cycling group and the control group, in patients with severe motor function deficits at baseline. Patients in the control group performed significant less sports at 12 months (mean Baecke/sport-baseline 3.07 +/- 1.21, mean Baecke/sport-12 months 1.43 +/- 0.98; p = 0.01). Furthermore, all groups showed significant changes over time in all measures at three months (except Physical Activity Scale for Individuals with Physical Disabilities, diary METs-minutes-moderate) and 12 month and additionally in a subgroup with severe motor function deficits (except diary METs-minutes-sedentary). CONCLUSION: When active cycling combined with education is used in subacute patients with severe motor function deficits, more sport participation might be observed after one year. No other significant group differences were found over time. In all groups, however, patients showed significant improvement over time in physical activity measures. Future work is needed to explore the most effective coaching approach after an aerobic training program.

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