What matters to program partners when implementing a community-based exercise program for people post-stroke? A theory-based qualitative study and cost analysis.
Gayatri Aravind, Kainat Bashir, Jill I Cameron and 7 others
PMID 37645234WHAT IT FOUND
Managers chose stroke exercise programs based on reputation and cost, while instructors felt nervous without prior experience with mobility issues.
Healthcare partners helped staff gain confidence, but clear roles and funding were needed to sustain the program.
Key findings
01Managers' decisions to adopt the program were driven by the reputation of developers, scientific evidence, and the ability to schedule classes during non-peak hours.
02Fitness instructors reported initial nervousness and difficulty grouping participants with varying abilities, but gained confidence as they delivered more classes.
03Healthcare partners struggled with role clarity, as instructors sometimes viewed them as supervisors rather than supportive colleagues.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study focused on first-time implementation, so findings may not reflect long-term sustainability challenges. Data were collected up to 8 months post-intervention, relying on participant recall. The sample was limited to three sites in Ontario, Canada, which may not generalize to other regions or healthcare systems. Cost estimates are based on a specific program model and local wage rates, so they may not apply directly to other programs.
Declared interests
The project was funded by the Heart and Stroke Foundation. One author (NMS) held a Heart and Stroke Foundation Mid-Career Investigator Award.
The easy way to misread this
Do not interpret the cost estimates or stakeholder recommendations as evidence that the TIME™ program improves patient health outcomes. This study describes the implementation process and provider experiences, not the clinical efficacy of the exercise intervention.