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Table 2 Proximal objectives and strategies for programme content

From: Synthesising practice guidelines for the development of community-based exercise programmes after stroke

Proximal objectives & recommended strategies Ev count Au Ca1 Ca2 Ca3 Ca4 Ca5 Eu Ne NZ SA Si UK1 UK2 UK3 US1 US2 US3 US4 US5
[41] [37] [42] [38] [43] [1] [44] [3] [48] [36] [49] [45] [47] [35] [39] [40] [34] [2] [46]
1 Increase muscle strength   10 X   X   X    X X    X   X X X   X  
  a. Lower limb strengthening 1 8    X   X X   X       X   X X X  
  b. Upper limb strengthening 1 10   X X   X X   X     X   X   X X X  
  c. Trunk and core muscle strengthening 2 3    X            X   X    
2 Increase aerobic endurance   12   X X   X X X X X    X   X X X   X  
  a. Treadmill training 1 6   X X   X    X         X   X  
  b. Use of static bicycle 1 3    X            X   X    
  c. Other large muscle group aerobic activity 2 2    X            X      
3 Regain and maintain normal joint range of movement   5    X          X   X   X   X  
  a. Lower limb stretching 2 3   X X            X      
  b. Upper limb stretching 1 4   X X    X   X            
  c. Trunk stretching 2 2    X            X      
  d. Lower limb movement through range 2 2   X             X      
  e. Upper limb movement through range 2 3   X   X           X      
  f. Unspecified stretch/ range of movement exercises 3 5    X X         X     X   X  
4 Enhance sensorimotor functions required for functional activity   7   X X X         X   X X X    
  a. Standing balance training 1 5    X   X X         X     X  
  b. Sitting balance training 1 4    X   X    X           X  
  c. Aquatic balance training 1 2       X             X  
  d. Unspecified balance training 1 3       X       X     X    
  e. Cyclic movements of paretic arm 2 3         X       X     X  
  f. Proprioceptive & kinaesthetic training 2 6   X   X X    X X          X  
  g. Mental rehearsal of upper limb movements 1 8 X X   X X X    X    X       X  
5 Enhance functional ability   12 X X X X X    X X    X   X   X X X  
  a. Standing up & sitting down practice 1 7   X X   X    X X    X   X      
  b. Step training / stair climbing 1 5    X   X          X   X   X  
  c. Walking (including treadmill training) 1 11 X X X   X X    X    X   X   X X X  
  d. Walking with rhythmic cueing 1 6 X     X X   X X          X  
  e. Paretic upper limb task-related training 1 11 X X   X X X   X X    X   X    X X  
  f. Bilateral upper limb task-related training 1 5 X     X     X    X       X  
6 Establish & maintain motivation for regular physical exercise   6 X   X       X    X X X      
  a. Address personal beliefs & attitudes 2 1               X      
  b. Promote personal goal-setting 2 3          X    X   X      
  c. Use motivational interviewing 2 1             X        
  d. Promote use of personal reflective diaries 3 1               X      
  e. Promote use of personal exercise record including repetitions, load and time spent 3 2               X X     
  f. Use positive feedback 2 1             X        
  g. Emphasise enjoyment 3 2    X            X      
7 Develop self-management skills for ongoing physical exercise   1    X                 
  a. Educate for self-monitoring for adverse events 3 1               X      
  b. Promote active problem-solving 3 3          X    X       X  
  c. Develop self-efficacy skills 3 2    X          X        
  d. Encourage self-monitoring to set appropriate exercise levels 3 2    X            X      
  e. Encourage independent practice of exercises 3 2    X            X      
  f. Provide guidance booklets 3 1               X      
  1. Ev = highest level of evidence presented for strategy.
  2. n = number of guidelines explicitly including objective or strategy.
  3. Au = Australia; Ca = Canada; Eu = Europe; Ne = Netherlands, NZ = New Zealand; SA = South Africa; Si = Singapore.