Due to medical advances, survivability after stroke is increasing. Intensive rehabilitation focusing on regaining physical, cognitive, and language function, is often necessary after stroke. However, stroke survivors are at risk of chronic disability, depression, and social isolation. Community-based providers, such as adaptive recreation programs, are often challenged to continue the long-term job of rehabilitation and community reintegration after stroke. The objective of this study was to explore the effects of adaptive cycling participation (using modified equipment or assistive devices) on aspects of physical, psychological and social resilience in stroke survivors. We hypothesized that participants, who engaged in a 16-week cycling program, would demonstrate improvement on measures of all three aspects of resilience.

The current study utilized a longitudinal design (baseline, 8, and 16 weeks). Outcome measures include: resting heart rate, 10 Meter Walk Test (10MWT), 2 Minute Walk Test (2MWT), Timed Up and Go, UW-Self-efficacy Scale, NeuroQOL Positive Affect and Well-being, Connor-Davidson Resilience Scale, NeuroQOL Satisfaction with Social Roles and Activities (SSRA), Interpersonal Support Evaluation List. Due to sample size and exploratory design, we calculated effect sizes.

We enrolled 18 stroke survivors (ages 25–72) in the study. Outcomes were available at all time points for 10–18 participants depending on the measure. Pairwise comparisons were calculated between baseline to 8-weeks and baseline to 16-weeks. We observed change score effect sizes>0.5 for one social and two physical measures. For baseline to 8-weeks, the NeuroQOL-SSRA had a medium effect (Cohen's d=0.564). For baseline to 16-weeks, the 2MWT and 10MWT had large and medium effects respectively (d=1.068 & 0.612).

The results highlight the importance of exploring: (1) the influence of adaptive recreation on not only physical but social outcomes. Due to the exploratory design of this pilot, future research is warranted.