Partnering to Increase Access to Community Exercise Programs for People With Stroke, Acquired Brain Injury, and Multiple Sclerosis

Background:The purpose of this article is to describe the development and evaluation of a task-oriented group exercise program, delivered through a municipal recreation program, for community-dwelling people with neurological conditions.Methods:Physical therapists (PTs) at a rehabilitation hospital partnered with a municipal recreation provider to develop and evaluate a 12-week exercise program for people with stroke, acquired brain injury, and multiple sclerosis at 2 community centers. Fitness instructors who were trained and supported by PTs taught 1-hour exercise classes twice a week. In a program evaluation of the safety, feasibility and effects of the program, standardized measures of physical function were administered before and after the program.Results:Fourteen individuals (mean age: 63 years) participated and attended 92% of exercise classes, on average. Two minor adverse events occurred during 293 attendances. Improvement in mean score on all measures was observed. In people with stroke, a statistically significant improvement in mean Berg Balance Scale (mean ± SD change = 3 ± 2 points, P = .016, n = 7) and 6-minute walk test scores (change = 26 ± 26 m, P = .017, n = 9) was observed.Conclusions:This model of exercise delivery provides people with neurological conditions with access to a safe, feasible and potentially beneficial exercise program in the community.

Upstream Social Marketing

The benefits of physical activity (PA) are well recognized. While the benefits of PA contribute to a higher quality of life, physical inactivity remains a population-wide plague around the world. The health risks associated with inactivity are disproportionately high among those with low-incomes. While the barriers hindering an active lifestyle among low-income persons are well known, there is a paucity of literature on the perspectives of those that are providing recreation services to low-income citizens. It is anticipated that understanding the professionals’ perspectives may help refine municipal recreation policies and procedures in order to better reach and serve low-income citizens. This study sought to understand the benefits of and challenges to implementing programs designed for low-income citizens. Framed by social marketing theory, key informant interviews and a focus group were conducted with recreation professionals from Vancouver Island, British Columbia, Canada ( N = 9). Social marketing can be a powerful way to make sense of how policies and programs are positioned by recreation professionals and offered to their less well-resourced patrons. Implications for practice include delivering programs outside of facility walls, using word of mouth as a trusted communication method, developing subsidy policies, seeking external funding sources, and relying on partnerships to facilitate delivery and recruitment. By focusing on the recreation professional, this study reveals the importance of targeting upstream audiences in order to effect change for the end users. Future research in other social service professions might benefit from a similar approach to advancing service delivery.