Neuropilates Compared to General Exercise Classes in Chronic Stroke

Dr. John Bartlett

Status: Completed

Conditions: Stroke

Treatments: Procedure: Home 'Neuropilates' exercise instructions.; Procedure: Supervised General Exercises Group Class; Procedure: Supervised Neuropilates Group Class; Procedure: Home 'General' exercise instructions.

Study type: Interventional

Funder types: Other

Identifiers

NCT04491279

ITSligo EC

Details and patient eligibility

About

This is a pilot randomised controlled feasibility study investigating the effects of a neuropilates exercise class compared to a generalised exercise in the post stroke population. This study is being conducted as part of an MSc qualification at the Institute of Technology, Sligo in Ireland. The study will be conducted in conjunction with Sligo University Hospital and it attained ethical approval through the relevant University Hospital Ethics Committee.

Full description

Pilates is an exercise form created by Joseph Pilates in the 1920s. It is a programme of mind-body exercise focusing on strength, core stability, flexibility, muscle control, posture and breathing. Neuropilates is the practice of clinical pilates in patients with a neurological condition. The exercise is ideally led by a clinician with experience and expertise in the area and uses postural, positional and equipment adaptations as necessary to suit the needs of the client. The benefits derived from pilates exercise of balanced strength with improved alignment, postural control and flexibility, could be favourable to post stroke patients who often have one-sided loss of strength and muscle length and subsequent adverse postural adaptations and abnormal movement patterns.

This study aims to investigate the effects of a 6-week neuropilates class in post stroke patients, when compared with a 6-week generalised exercise class. Participants will be assessed before and after partaking in either class in order to examine their gait, functional independence and spasticity. Participants will then be randomly assigned to either the 6-week neuropilates class or generalised exercise class. Participants will be 6 or more months post stroke and finished their formal rehabilitation. Participants should not be involved with any other rehabilitation therapies / hydrotherapy / gym services for the duration of the study. We will aim to recruit 30 participants to the study. The intervention group will attend a once-weekly 60-minute neuropilates exercise class over 6 weeks facilitated by the principle investigator (a chartered physiotherapist who is also a pilates instructor). The control group will attend a once weekly, 60-minute generalized exercise class which will be designed by a chartered physiotherapist to address strength, cardiorespiratory fitness and mobility. Both exercise classes will take place in the Physiotherapy Department in St. John's Hospital, Sligo, Ireland

Enrollment: 30 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Aged > 18 years
2. Diagnosis of chronic stroke (>6 months post stroke event, as defined by Bernhardt et al, 2017) and formal rehabilitation completed.
3. Able to transfer (sit to stand and lateral transfers) independently with or without assistive device
4. Access to transport to enable attendance at one class per week
5. Cognitive ability to understand the programme.

Exclusion criteria

1. Involvement in other studies or rehabilitation programmes.
2. Severe cognitive deficits or difficulty following instructions.
3. Significant hearing difficulties.
4. Significant visual deficit
5. Uncontrolled pain or uncontrolled high blood pressure

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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30 participants in 2 patient groups

Neuropilates class.

Experimental group

Description:

Will attend a once-weekly 60-minute neuropilates exercise class over 6 weeks facilitated by the principle investigator (chartered physiotherapist and pilates instructor). Pitched at a beginner level focused on the core elements of neuropilates and progressing week on week as appropriate. Includes a warm up, cool down and neuropilates exercises in line with the teaching of APPI (the Australian Physiotherapy and Pilates Institute). Exercises may be completed on mats, chairs, gym balls, plinths and in standing, depending upon the ability level of the participant. Two classes running with 8 participants in each based on their initial assessment into the higher and lower functionally independent participants. Participants will be given a home exercise programme weekly based on exercises from the class and will be asked to complete these independently at home twice more during the week and to keep a training diary.

Treatment:

Procedure: Supervised Neuropilates Group Class

Procedure: Home 'Neuropilates' exercise instructions.

Generalised exercise class.

Active Comparator group

Description:

Will attend a once weekly, 60-minute generalized exercise class which will be designed by a chartered physiotherapist to address strength, cardiorespiratory fitness and mobility. Exercises will be more functional and generic than in the pilates classes and will be conducted in a circuit style, including mobility practice, sit to stand practice, cycling with the motomed, and general upper and lower limb strengthening. Warm up and cool downs will also be a feature of this class. Participants will be also be given a home exercise programme based on exercises completed in the class and will be asked to complete these exercises twice more during the week and to keep a training diary.

Treatment:

Procedure: Home 'General' exercise instructions.

Procedure: Supervised General Exercises Group Class