Virtual Seated Exercises for Stroke

(V-PASE Trial)

Recruiting at 4 trial locations

Overseen By Chihya Hung, MScPT

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of British Columbia

Disqualifiers: Formal exercise, Physical activity, Severe vision, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

Duration: 10 weeks

100 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if seated exercises delivered online can improve balance, mobility, quality of life, and heart health in individuals with movement difficulties due to a stroke. Participants will join either a 10-week seated exercise program called Virtual Physical Activity Seated Exercises (V-PASE) or a shorter 2-week Boot Camp later. It suits those who had a stroke over 6 months ago, have trouble walking, and can stand up from a chair. As an unphased trial, this study provides a unique opportunity to contribute to research that could enhance rehabilitation options for stroke survivors.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these virtual seated exercises are safe for stroke patients?

Research has shown that seated exercises are generally safe for people who have had a stroke. One study examined their effects on balance and movement in stroke survivors, including 337 participants, and found improvements without major safety concerns. Another study focused on a home-based seated exercise program for heart health in adults with long-term neurological conditions, also showing positive results without significant side effects.

These findings suggest that virtual seated exercises, like those in this trial, are well-tolerated. Participants typically experience improvements in balance and movement, with no serious side effects reported. This is encouraging for those considering joining the trial, as it indicates a good safety record for the treatment. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Virtual Physical Activity Seated Exercises (V-PASE) for stroke recovery because this innovative approach uses virtual technology to enhance accessibility and engagement in rehabilitation. Unlike traditional physical therapy that often requires in-person sessions and full mobility, V-PASE allows stroke survivors to participate in seated exercises from the comfort of their own home, making it more accessible for those with limited mobility. Additionally, the virtual component adds an interactive element, potentially increasing motivation and consistency in patients' rehabilitation routines. This approach could significantly improve participation and outcomes in stroke recovery, offering a promising alternative to existing methods.

What evidence suggests that virtual seated exercises are effective for stroke-related mobility impairment?

This trial will compare two groups: one will receive a 10-week seated exercise program, while the other will participate in a delayed 2-week program after the trial period. Studies have shown that seated exercises can enhance balance and movement in stroke survivors. Research indicates these exercises may improve heart and blood vessel health. Some studies also suggest that exercises using virtual reality can enhance walking and overall movement recovery in stroke patients. Overall, early findings suggest these exercises could be a promising way to improve health and quality of life after a stroke. ^{2 3 6 7 8}

Are You a Good Fit for This Trial?

This trial is for adults who've had a stroke at least 6 months ago, can stand up from a chair with or without help, and have some mobility issues. They should be able to exercise safely for an hour, speak English, and have access to the internet and email via a computer or tablet.

Inclusion Criteria

I am legally considered an adult in my region.

Able to communicate in English

Have access to a tablet, computer, or laptop with internet and email access

Exclusion Criteria

You have severe problems with your vision, hearing, speaking, or thinking that makes it hard for you to use a computer or talk on video calls.

I have a condition like chronic pain that stops me from doing certain physical activities.

I have a serious health condition like Parkinson's or another active cancer.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants are randomized to a 10-week seated exercise program or a delayed 2-week Boot Camp program, with sessions conducted virtually

10 weeks

3 virtual sessions per week

Follow-up

Participants are monitored for safety and effectiveness after treatment

8 weeks

Delayed Treatment (Boot Camp)

Participants in the delayed group complete a 2-week seated exercise program following the 10-week active trial period

2 weeks

3 virtual sessions per week

What Are the Treatments Tested in This Trial?

Interventions

• Virtual Physical Activity Seated Exercises (V-PASE)

Trial Overview

The study tests if online seated exercises can improve balance, mobility, quality of life, and heart health in those with stroke-related impairments. Participants will either do a 10-week program immediately or join a shorter Boot Camp after.

How Is the Trial Designed?

Group I: 10-week group Experimental Treatment 1 Intervention

Will receive a 10-week seated exercise program, occurring 3 times per week. Sessions will be 60 minutes in duration.

Group II: Delayed 2-week group (Boot Camp) Active Control 1 Intervention

The Boot Camp group will complete a 2-week seated exercise program following the 10-week active trial period.

Who Is Running the Clinical Trial?

University of British Columbia

Lead Sponsor

Trials

1,506

Recruited

2,528,000+

Michael Smith Foundation for Health Research

Collaborator

Trials

20

Recruited

6,100+

Canadian Institutes of Health Research (CIHR)

Collaborator

Trials

1,417

Recruited

26,550,000+

Published Research Related to This Trial

Using Seated Power Assisted Exercise (PAE) equipment significantly helps individuals recovering from stroke transition from early rehabilitation to long-term recovery, as reported by participants in a qualitative study of 8 stroke survivors.

Participants expressed that PAE not only aids physical recovery but also positively reframes their experience of stroke, suggesting that community-based PAE programs are valuable for ongoing rehabilitation and should be further developed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Users' experience of community-based power assisted exercise: a transition from NHS to third sector services. Young, R., Broom, D., O'Brien, R., et al.[2022]

The study demonstrated that using an internet-based app and chair sensor to monitor and guide home exercises for stroke patients is feasible and safe, with all 10 participants completing the program and exceeding their exercise goals.

Participants reported high satisfaction with the system, and there were no adverse events, suggesting that this technology could effectively support increased exercise adherence and potentially improve physical function after stroke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"Connecting patients and therapists remotely using technology is feasible and facilitates exercise adherence after stroke". Simpson, DB., Bird, ML., English, C., et al.[2020]

Eighteen randomized controlled trials were reviewed, revealing that interventions like aerobic and resistance training, electrical stimulation during walking, and robot-assisted arm therapy significantly increased physical activity in stroke patients.

Despite some effective interventions, the overall quality of evidence was low, and many studies showed no significant differences in physical activity, highlighting the need for more robust research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of interventions aimed at improving physical activity in individuals with stroke: a systematic review. Aguiar, LT., Nadeau, S., Martins, JC., et al.[2021]

Supervised exercise delivered via telehealth may help stroke survivors increase their physical activity levels, addressing a common barrier to rehabilitation.

This scoping review will systematically gather and analyze evidence on the efficacy, acceptability, safety, and feasibility of telehealth exercise interventions for chronic conditions, particularly focusing on stroke recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supervised exercise delivered via telehealth in real time to manage chronic conditions in adults: a protocol for a scoping review to inform future research in stroke survivors. Ramage, ER., Fini, NA., Lynch, EA., et al.[2023]

Regular physical activity significantly benefits both primary and secondary stroke prevention by positively influencing various vascular risk factors such as obesity and hypertension.

After a stroke, tailored physical activity can help reduce the risk of recurrence, improve brain function, and enhance quality of life, but it must be adjusted based on individual health conditions and neurological impairments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Primary and Secondary Stroke Prevention: Physical Activity]. Padlina, G., Scutelnic, A., Salmen, S.[2021]

In a study of 186 stroke survivors, daily ambulatory activity (AA) increased during the subacute phase for those with mild to moderate disabilities, indicating that physical activity is crucial for recovery in this group.

Baseline levels of AA were significantly associated with better functional outcomes (measured by the modified Rankin scale) and quality of life (measured by EQ-5D-3L) at 6 months, highlighting the importance of monitoring and encouraging physical activity after a stroke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ambulatory activity in stroke survivors associated with functional outcome and quality of life: An observational cohort study. Kaffenberger, T., Bernhardt, J., Koehler, JL., et al.[2022]

Game-based exercise significantly improved hand strength and motor function in stroke patients compared to traditional manual exercises, based on a study involving 50 participants over 6 weeks.

Patients engaging in game-based exercises reported higher levels of motivation and enjoyment, indicating better compliance with the rehabilitation program, without an increase in pain or fatigue.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Game-based hand resistance exercise versus traditional manual hand exercises for improving hand strength, motor function, and compliance in stroke patients: A multi-center randomized controlled study. Park, JS., Lee, G., Choi, JB., et al.[2020]

A study involving 15 community-dwelling adults with chronic stroke revealed that they conceptualize physical activity (PA) in three main ways: as exercise-related activities, as necessary for daily living tasks, and as a means to avoid sedentary behavior.

Understanding these perceptions of PA can help develop effective interventions to increase physical activity levels post-stroke, which is important for improving overall health and reducing sedentary lifestyles.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How Adults With Stroke Conceptualize Physical Activity: An Exploratory Qualitative Study. Bailey, RR., Stevenson, JL.[2022]

The VirTele intervention, which combines virtual reality exergames with a telerehabilitation app, was found to be a feasible and effective alternative for rehabilitating upper extremity function in chronic stroke survivors, with improvements observed in motor function and motivation compared to conventional therapy.

Despite some technical issues, most participants found the VirTele technology easy to use, and 75% of those in the experimental group showed increased motivation, suggesting that this approach could enhance engagement in rehabilitation activities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rehabilitation of Upper Extremity by Telerehabilitation Combined With Exergames in Survivors of Chronic Stroke: Preliminary Findings From a Feasibility Clinical Trial. Allegue, DR., Higgins, J., Sweet, SN., et al.[2022]

Participants with chronic stroke found that video games served as a motivating tool for physical activity rather than traditional treatment, promoting whole-body movement.

The group setting of the video-game intervention fostered a sense of community and support, suggesting that this approach could be a cost-effective way to maintain mobility and prevent inactivity in individuals with chronic stroke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A video-game group intervention: Experiences and perceptions of adults with chronic stroke and their therapists: Intervention de groupe à l'aide de jeux vidéo : Expériences et perceptions d'adultes en phase chronique d'un accident vasculaire cérébral et de leurs ergothérapeutes. Rand, D., Givon, N., Avrech Bar, M.[2018]

This longitudinal observational study will track physical activity levels in stroke survivors for 2 years after rehabilitation discharge, aiming to understand how physical activity relates to cardiovascular risk factors and mobility.

The study will include 77 participants and measure various outcomes, such as moderate to vigorous physical activity and cardiovascular health, to identify factors influencing long-term physical activity in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What is the relationship between physical activity and cardiovascular risk factors in stroke survivors post completion of rehabilitation? Protocol for a longitudinal study. Fini, NA., Bernhardt, J., Holland, AE.[2022]

This randomized clinical trial will assess the effects of multimodal physical exercises in three different environments (real, virtual, and combined) on post-stroke patients, involving 36 participants over 15 weeks.

The study aims to evaluate improvements in health-related quality of life and various functional capacities, using innovative outcome measures aligned with the International Classification of Functioning, Disability and Health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A combination of multimodal physical exercises in real and virtual environments for individuals after chronic stroke: study protocol for a randomized controlled trial. Mazzini, NA., Almeida, MGR., Pompeu, JE., et al.[2020]

Cardiorespiratory training significantly reduces disability in stroke survivors, with a moderate effect size, indicating that such exercise can improve mobility and balance during rehabilitation.

The study found no serious adverse events associated with exercise, suggesting that physical training is a safe intervention for stroke survivors, although it did not influence mortality rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical fitness training for stroke patients. Saunders, DH., Sanderson, M., Hayes, S., et al.[2023]

Citations

1.

neurorehab.med.ubc.ca

neurorehab.med.ubc.ca/v-pase/

V-PASE - Neurorehabilitation Research Program

Thus, the V-PASE study aims to investigate the effects of delivering a online seated exercise program balance and walking capacity in those with a stroke and ...

2.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC10226004/

The influence of seated exercises on balance, mobility, and ...

These findings suggest beneficial effects of seated exercises on balance and mobility outcomes in those with a stroke, compared with standard therapy or an ...

3.

frontiersin.org

frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2025.1477969/full

A seated virtual exercise program to improve ...

This study aimed to investigate the effects of a seated home-based tele-exercise regimen on cardiovascular function in adults with chronic neurological ...

4.

jmir.org

jmir.org/2024/1/e59136/

The Effectiveness of Therapeutic Exercise Interventions ...

This study aims to evaluate the effectiveness of therapeutic exercise interventions with virtual reality (VR) training on balance and walking.

5.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC4880012/

Effectiveness of Virtual Reality Exercises in STroke ...

Evidence suggests that increasing intensity of rehabilitation results in better motor recovery. Limited evidence is available on the effectiveness of an ...

6.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC11979118/

A seated virtual exercise program to improve ...

This study aimed to investigate the effects of a seated home-based tele-exercise regimen on cardiovascular function in adults with chronic neurological ...

7.

clinicaltrials.gov

clinicaltrials.gov/study/NCT02285933

Virtual Reality Exercise for Stroke Rehabilitation in ...

The purpose of this study is to determine if the addition of 10 to 12 sessions of sitting balance exercises using virtual reality training will provide ...

8.

tandfonline.com

tandfonline.com/doi/abs/10.1080/09593985.2024.2422510

Remote delivery of seated exercises transfers to improved ...

This case-report investigates the effect of a novel, remotely delivered 2-week seated exercise program on mobility in a person living with stroke.