Abstract WP454: Benefits of a Multidisciplinary Stroke Wellness, Exercise and Education Program (SWEEP) for Chronic Stroke Survivors

Abstract

Background and Purpose:: Stroke patients typically receive rehabilitation for only a limited time period after stroke. However, therapies in the chronic phase after stroke are often needed to both maintain and improve function. In addition, many patient lack knowledge about stroke and as a result are frequently non-compliant with secondary stroke prevention measures despite stroke education during hospitalization. The SWEEP program was developed to address these issues. The purpose of this study was to evaluate health outcomes before and after participation in the program. Methods: The SWEEP consisted of twice weekly group sessions for 10 weeks. The sessions included 45 minutes of focused exercise led by therapists and 15 minutes of multidisciplinary education on secondary stroke prevention and adjustment to life after stroke. Criteria for admission into the program included: greater than one year since stroke, intact cognition, and ability to transfer with no more that moderate assist. Outcome measures were collected at baseline, at the end of 10 weeks of participation, and at 3- and 6-months post participation. The measures assessed functional status (grip strength, Sit-to-Stand time, Timed-Up-And-Go (TUG),) and indicators of secondary stroke prevention (systolic and diastolic blood pressure (SBP, DBP), LDL, HgbA1c and weight). We used paired (sign rank test) and repeated measure analyses (ANOVA). Results: There were 23 participants between Fall 2016 to Spring 2019, 21 were males. They were 4.74±6.75 years after stroke. There was improvement in grip strength (p=0.006), Sit-to-Stand (p=0.004) and TUG (p=0.003) between baseline and at the end of the program. SBP was reduced to <130 at 3 months and was maintained at 6 months (ANOVA, p=0.003). Four out of 5 people reduced their abnormal HgbA1C (>7), 2 out of 2 reduced their elevated LDL (>100) and 12 people lost weight. Conclusions: The SWEEP program was largely effective in improving functional status and secondary stroke prevention measures. Continued emphasis on secondary stroke prevention is needed for our patient population. A larger study is needed to confirm the results.