Stroke is the most common cause of complex disability (Adamson et al.2004); and the role of exercise in stroke care is recognised by the Royal College of Physicians’ National Clinical Guidelines for Stroke (2008) which in the section on rehabilitation recommends:
‘After stroke, all patients should participate in aerobic training unless there are contraindications unrelated to stroke’
The NERS Exercise after Stroke intervention provides an opportunity for patients to attend group evidence based exercise programme based on the evidence from the Cochrane review of physical fitness training for stroke patients (Saunders et al 2009) and the random controlled trial (Mead et al. 2007), designed to improve mobility and quality of life, led by Level 4 Specialist Exercise and Fitness Training after Stroke course, developed by Queen Margaret University and University of Edinburgh and administered by Later Life Training.
The scheme has been supported by the Welsh Assembly Government, Welsh Local Government Association, Later Life Training, Chartered Society of Physiotherapy, Local Authorities, Public Health Wales (PHW) and Local Health Boards (LHB’s).
The Principal Aims of the Scheme
- To offer a systematic and safety controlled system of referral to NERS Exercise and Fitness After Stroke Intervention
- To offer a systematic and safety controlled system of referral to suitable independent exercise.
- To provide safe and effective exercise for clients needs.
- To improve the clients cardio respiratory fitness, strength, (and balance and co-ordination)
- To increase the clients functional ability.
- To increase the clients confidence.
- To increase the clients mental health and well being.
- To decrease the clients social isolation.
- To increase the clients long term adherence to physical activity.
- The scheme represents best practice and meets with current National guidelines.
- All exercise professionals operating the scheme are trained to NVQ Level 4 have a qualification that meets occupational standard D449 working with referred patients, a Level 4 Exercise After Stroke Instructor qualification which is endorsed by Skills Active.
- All exercise professionals are suitably insured and registered with the Register of exercise Professionals (REP’s).
The scheme is targeted at clients who have suffered a stroke and been assessed by health professional to ensure suitability for community scheme; these clients may be continuing to receive active therapy which will run simultaneously alongside NERS intervention; this must be recorded on referral form.