The effect of a telehealth chair-based exercise intervention on motor function in stroke survivors with a mobility impairment

Physical activity plays a key role in maintaining a healthy lifestyle. However, approximately 7% of Canadians live with a mobility impairment, decreasing their ability to participate in daily activities and subsequently increasing their time spent in sedentary behaviours (sitting). Living a sedentary lifestyle is associated with poor health and risk of cardiovascular disease, particularly in those with a compromised health.
In the elderly, chair-based exercises are shown to improve mobility function and quality of life, with general compliance shown to be better than standing or dynamic exercises. During the current COVID-19 pandemic, there is limited access to group activities and therapies due to social distancing requirements. Therefore, telehealth (videocall) delivery of exercise interventions is of great importance in helping to maintain a healthy lifestyle. Our project will investigate the effect of delivering a telehealth chair-based exercise intervention on motor function in stroke survivors with a mobility impairment (unable to walk without assistance of one person). Secondary outcomes include balance and quality of life. The results can help develop telehealth interventions that can be delivered in rural communities.

Beyond VO2peak: Understanding exercise-induced in cardiovascular function after stroke

Stroke is the leading cause of neurological disability in Canada. Most stroke survivors have a number of other related conditions, including heart disease, diabetes, obesity and high blood pressure, which contribute to their risk of additional strokes. Exercise not only improves fitness, it also has the potential to reduce the risk of heart disease and stroke.

Dr. Ada Tang is working to understand how aerobic exercise can influence stroke risk factors and heart and arterial function in those who have already had a stroke. She will be evaluating the effects of an exercise program on 51 participants between the ages of 50 and 80, all of whom are one-year post stroke and can walk short distances without help. Participants will be randomly assigned to either an aerobic exercise program, or to a balance and flexibility program. Both programs are conducted at Vancouver General Hospital and feature three one-hour sessions per week. Program participants are carefully monitored during their exercise sessions. The participants’ fitness level and blood pressure will be tested at the start and the end of the six-month exercise program and two months after the end of the program to see if the benefits are maintained. Echocardiograms will be performed to look at heart size and function, blood tests will measure cholesterol levels and other signs of inflammation, and other tests will be done to determine how exercise can improve artery flexibility, heart rate and rhythm.

This study will help us better understand how exercise after stroke can improve heart function and heart health. Research results will help health professionals understand the best way to promote a healthy lifestyle after stroke to lower the risk of heart disease or another stroke.

Neuromechanical determinants of the metabolic cost of healthy and pathological gait

Walking is a vital means of mobility for most people. While walking is easy for healthy people, for individuals who have suffered a stroke and have partial paralysis of one side of their body (hemiparesis), walking can be difficult. Often, these people will avoid walking, because their gait requires nearly twice the metabolic energy of healthy gait. These increased energy demands may partially explain why stroke patients tend to walk slowly and avoid carrying heavy loads, impairing their daily activities. Dr. Max Donelan’s research aims to advance our understanding of the fundamental principles that underlie locomotion physiology and to apply these principles to directly improve human health. Across the range of his research, he uses a combination of mathematical modeling and empirical experimentation, which involves techniques from biomechanics, energetics and neurophysiology. To study the metabolic cost of gait after stroke, Dr. Donelan is determining the important mechanisms that make normal walking easy and energy-efficient, and how these mechanisms are compromised in individuals with stroke-related paralysis. The results of his research will guide the design of rehabilitation strategies and devices aimed at lowering metabolic cost and increasing patient mobility.

The British Columbia Fatigue Research Group

This award funds the creation of a research team focused on understanding fatigue associated with neurologic and neuromuscular disorders. The goal is to develop an interdisciplinary approach to research, exploring the prevalence of fatigue among individuals with disabilities, how and to what extent the condition influences function and quality of life, what are the costs to society and the health system and, ultimately, how to improve treatment.