Background: Stroke recovery occurs rapidly within the first months but is often incomplete. Rehabilitation services are limited in the community and recovery often plateaus.
Aim: We aimed to establish a cost-effective, student supported, community chronic stroke rehabilitation boot camp for upper limb recovery. Objectives were to evaluate clinical efficacy and participant experiences in participating in the boot camp.
Methods: Thirty-nine people with chronic stroke and upper limb impairment were invited to participate in a randomised cross-over controlled trial to evaluate a 5-week boot camp program. Boot camp was co-designed with people who had experienced stroke. Therapy was tailored to the individual’s impairments and goals and delivered in groups of four (90h therapy over 5 weeks). Rehabilitation was delivered by an experienced physiotherapist and supported by allied health students. The control phase was 5-weeks of usual care. Primary outcome measure was the Fugl-Meyer. Secondary measures assessed upper limb activity, quality of life, and self-efficacy. An interview was conducted by a stroke survivor to understand participant experiences.
Results: Boot camp led to 10.8 point (SD 5.7) Fugl-Meyer improvement, exceeding usual care (0 point change; t(37)=10.85, p<0.001) and the minimal clinically significant difference (5.25 points). Upper limb activity (p<0.001) and self-efficacy (p=0.004) improved, but not quality of life (p=0.134). Participants reported mental health and motivation benefits. There was a common theme of enjoying the peer support and social engagement during the program.
Conclusion: Boot camp promotes significant arm recovery in people with chronic stroke. Benefits of the program include psychological and social support.