Exercise instructor-led functional training programme for community dwelling stroke survivors: A qualitative study

Norris, Meriel; Kilbride, Cherry; Mohagheghi, Amir A.; Victor, Christina

doi:10.12968/ijtr.2013.20.12.597

Cited by 13 publications

(36 citation statements)

References 22 publications

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“…, Norris et al . ). In three studies (20%; 4 articles), the fitness instructors had experience working with people with disability (Elsworth et al .…”

Section: Resultsmentioning

confidence: 97%

“…, Norris et al . ), a 6‐month follow‐up ( n = 1 study; 7%) (Sims et al . ), and 4‐ and 10‐month follow‐ups ( n = 1 study; 7%; 2 articles) (Harrington et al .…”

Section: Resultsmentioning

confidence: 99%

“…, Norris et al . ) involving an exercise component and an education component. Exercise programmes were delivered in a group format ( n = 10 studies; 67%; 11 articles) (Hassett et al .…”

Section: Resultsmentioning

confidence: 99%

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Characterising community exercise programmes delivered by fitness instructors for people with neurological conditions: a scoping review

Merali

Cameron

Barclay

et al. 2015

Health Soc Care Community

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What is known about this topic• Emerging healthcare-recreation partnership model where physical therapists train and support fitness instructors who deliver exercise programmes in recreation centres.• Involvement of knowledgeable and experienced healthcare professionals supports credibility of community exercise programmes.• Model helps increase access to safe and appropriate exercise programmes in the community for individuals with physical disabilities. What this paper adds• Understanding of the nature and extent of literature describing evaluations of community exercise programmes delivered by fitness instructors for people with neurological conditions.• Research is needed across neurological populations, targeting outcomes related to activity, participation, health services and caregivers, with improved reporting on the role of healthcare professionals. AbstractA scoping review was conducted to characterise evaluations of community-based exercise programmes (CBEPs) delivered by fitness instructors to people with neurological conditions. Literature published from 1946 to April 2014 in MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews and the grey literature were searched. Search terms included community, programme, exercise, adult, brain disease and spinal cord disease. Two reviewers independently screened titles and abstracts for inclusion. One author reviewed full-text articles to evaluate eligibility. Studies were included if the study objective was to evaluate an exercise programme, the programme was community-based and delivered by fitness instructors, exercise participants were ≥18 years of age and had a neurological condition, and a full-text article was available and written in English. After reviewing 1785 titles and abstracts, 18 (1.01%) articles describing 15 studies were included in the review. One author completed data abstraction from the included studies. A second reviewer independently verified the extracted data for accuracy. Exercise programmes most commonly included people with stroke (47%) and Parkinson's disease (40%), incorporated a stand-alone (80%), multicomponent (20%), group (67%), individual (20%) and combined format (13%), strength training (40%) and functional/task-oriented training (40%), reported a minimum walking requirement (67%), and involved a healthcare professional (HCP) with various roles (53%), including training (27%), advising and supporting (33%). The most commonly examined participant outcomes were health-related quality of life (60%) and functional balance (47%). More research is needed to develop CBEPs targeting individuals with low ambulatory function and multiple neurological conditions, to develop recommendations for the involvement of HCPs in CBEPs and document their involvement, and to evaluate system-level outcomes such as cost, healthcare utilisation and impact on caregivers. The findings support a number of considerations to guide future research into CBEPs delivered by fitness instructors for individuals with neurological conditions.

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“…, Norris et al . ). In three studies (20%; 4 articles), the fitness instructors had experience working with people with disability (Elsworth et al .…”

Section: Resultsmentioning

confidence: 97%

“…, Norris et al . ), a 6‐month follow‐up ( n = 1 study; 7%) (Sims et al . ), and 4‐ and 10‐month follow‐ups ( n = 1 study; 7%; 2 articles) (Harrington et al .…”

Section: Resultsmentioning

confidence: 99%

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Characterising community exercise programmes delivered by fitness instructors for people with neurological conditions: a scoping review

Merali

Cameron

Barclay

et al. 2015

Health Soc Care Community

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“…To inform development of a trial protocol, we conducted a suite of investigations: A. Two mixed-methods before-and-after studies of ARNI training, delivered to long-term stroke survivors over 3 months: in one study, one-to-one training was provided twice-weekly (19); in another, weekly group-based training was offered (20,21 These studies provided data and experience to develop the trial protocol and to identify strategies to enhance intervention fidelity, to mitigate the effects of possible threats to fidelity, and to measure the different facets of fidelity during the trial (Table I).…”

Section: Overview Of Trial Development Workmentioning

confidence: 99%

Intervention fidelity: Developing an experience-based model for rehabilitation research

Poltawski¹,

Norris²,

Dean³

2014

J Rehabil Med

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Background: Intervention fidelity is concerned with the extent to which interventions are implemented as intended. Consideration of fidelity is essential if the conclusions of effectiveness studies are to be credible, but little attention has been given to it in the rehabilitation literature. We describe our experiences addressing fidelity in the development of a rehabilitation clinical trial, and consider how an existing model of fidelity may be employed in rehabilitation research. Methods: We used a model and methods drawn from the psychology literature to investigate how fidelity might be maximised during the planning and development of a stroke rehabilitation trial. We considered fidelity in intervention design, provider training, and the behaviour of providers and participants. We also evaluated methods of assessing fidelity during a trial. Results: We identified strategies to help address fidelity in our trial protocol, along with their potential strengths and limitations. We incorporated these strategies into a model of fidelity that is appropriate to the concepts and language of rehabilitation. Conclusion: A range of strategies are appropriate to help maximise and measure fidelity in rehabilitation research. Based on our experiences, we propose a model of fidelity and provide recommendations to inform the growing literature of fidelity in this discipline.

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“…Physiotherapists and SSs in the United Kingdom (UK) and US have cited EPs lack of knowledge and training on stroke as a barrier to EPs working with SSs (Rimmer, Wang, & Smith, 2008;Wiles et al, 2008). To overcome such barriers, physiotherapists and EPs have formed partnerships whereby physiotherapists educate EPs on stroke and support them in successfully delivering exercise programmes for SSs (Cramp et al, 2010;Harrington et al, 2010;Merali, Cameron, Barclay, & Salbach, 2015;Norris, Kilbride, Mohagheghi, & Victor, 2013;Reed, Harrington, Duggan, & Wood, 2010;Stuart et al, 2009). Unfortunately, EP-led exercise programmes and formal physiotherapy and EP partnerships are not commonly seen in the community (Best et al, 2012;Fullerton et al, 2007).…”

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confidence: 99%

A survey of exercise professionals’ barriers and facilitators to working with stroke survivors

Condon

Guidon

2017

Health Soc Care Community

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Stroke survivors (SSs) are largely inactive despite the benefits of exercise. Exercise professionals (EPs), skilled in exercise prescription and motivation, may have a role in promoting exercise among SSs. However, the number of EPs working with SSs is estimated to be low. This study aimed to investigate EPs' opinions on working with SSs by rating their agreement of barriers and facilitators to working with SSs. The study also investigated EPs skills, interest and experience working with SSs and the relationship between EPs' barriers and facilitators with their training on stroke. A descriptive cross-sectional study was conducted using a researcher-designed online survey between October and December 2015. Purposive sampling was used to survey EPs on the Register of Exercise Professionals in Ireland (n = 277). The response rate was 31% (87/277). Only 22% (19/86) of EPs had experience working with SSs. The primary barriers rated by EPs included insufficient training on psychological problems post-stroke (84%; 61/73), unsuitable equipment for SSs (69%; 50/73) and the level of supervision SSs require (56%; 41/73). The primary facilitators rated included access to suitable equipment (97%; 69/71), practical (100%; 71/71) and theoretical training (93%; 66/71) on stroke. Respondents with no training on stroke were significantly more likely to agree that insufficient training on psychological problems post-stroke and lack of experience were barriers. Seventy-six per cent of EPs (58/76) were interested in one-to-one exercise sessions with SSs but only 53% (40/76) were interested in group sessions. Eighty-two per cent of EPs (62/76) rated their motivational skills as good or very good but 42% (32/76) indicated having only acceptable skills dealing with psychological problems. Results indicate that EPs are interested in working with SSs despite limited experience and practical barriers. Training opportunities on stroke need to be developed; taking into account EPs' barriers, facilitators and skills along with access to suitable equipment.

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Exercise instructor-led functional training programme for community dwelling stroke survivors: A qualitative study

Abstract: Background: Action for Rehabilitation in Neurological Injury (ARNI) is a novel community-based

Cited by 13 publications

References 22 publications

Characterising community exercise programmes delivered by fitness instructors for people with neurological conditions: a scoping review

Characterising community exercise programmes delivered by fitness instructors for people with neurological conditions: a scoping review

Intervention fidelity: Developing an experience-based model for rehabilitation research

A survey of exercise professionals’ barriers and facilitators to working with stroke survivors

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