Feasibility, safety and outcomes of an online, remotely supervised neuropilates class in a post stroke patient: A case study

Abstract

Neuropilates, that is, the practice of pilates in a patient with a neurological condition, may benefit post stroke patients through improving their strength, postural control, alignment and stability, with previous studies showing significant improvements in balance and gait parameters post pilates interventions. This case study aimed to investigate the feasibility and outcomes of an online, remotely supervised one to one pilates class, once a week for 6 weeks with a post stroke patient. Outcomes measured included gait and balance through the “Timed Up and Go (TUG)” test, the “Five Times Sit to Stand (5TSTS)” test, the “Activities specific Balance Confidence (ABC) scale” and the “Tinetti” balance and gait assessment. Quality of life was also measured by the “Stroke Specific Quality of Life (SSQOL)” Scale and muscle tone was measured through use of the “Modified Ashworth Scale (MAS)”. Feasibility was assessed qualitatively based on information gathered from the client satisfaction questionnaire and the patient’s tolerance of the programme. Results demonstrated that the patient enjoyed and tolerated the programme well with modifications and that he would prefer online exercise training over face to face in the future. The patient improved his TUG score and his SSQOL score beyond the minimal detectable change. Smaller improvements were also seen in the 5TSTS test, the ABC scale and the Tinetti assessment. Mixed results were seen for muscle tone. Typical neuropilates exercise sets for post stroke patients in standing and seated positions are given as well as advice and protocols for ensuring high levels of safety with online exercising.