Resistance training (RT) improves muscle strength after stroke, but muscle power — the ability to generate force quickly — may be more important for maintaining mobility in people with stroke. Prior studies have shown feasibility of power training after stroke, yet many trials did not use structured periodisation strategies (for example, developing strength before progressing to power-specific work). The investigators developed a periodised power training programme, Power Exercise for Stroke Recovery (POWER), and previously demonstrated feasibility and potential benefits for muscle power, mobility and health-related quality of life. This protocol describes the next stage: a pilot multisite randomised controlled trial to test the feasibility of the trial design before a fully scaled trial.
This study is a pilot multisite randomised controlled trial to be conducted at McMaster University and the University of British Columbia in Canada. The trial will enroll participants who are community-dwelling and at least 6 months post mild to moderate stroke. Sixty participants will be randomised to one of two active, supervised resistance training programmes delivered three times per week over 10 weeks.
Eligible participants are adults at least 6 months following mild to moderate stroke. Specific inclusion and exclusion criteria and recruitment procedures were described in the source protocol; detailed participant screening criteria were not reported in the short article summary.
Participants will be randomly allocated to one of two interventions:
POWER: a periodised power training programme designed to emphasise sequential development of strength and then power. After a 1-week familiarisation, participants complete an intense strength-building phase during weeks 2–5, followed by a power training phase during weeks 6–10.
STRENGTH: a conventional resistance training programme following current physical activity recommendations. After the same 1-week familiarisation period, participants engage in a moderate-intensity strength-building programme from weeks 2–10.
Both programmes are delivered thrice weekly for 10 weeks and begin with a 1-week familiarisation consisting of low-intensity versions of each programme to acclimate participants to the exercises and procedures.
Both arms include supervised RT sessions three times per week across a 10-week intervention. The POWER arm specifically uses a periodised approach: an initial intense strength phase transitions to a targeted power phase to maximise the ability to produce force rapidly. The STRENGTH arm maintains moderate-intensity strength training throughout the active intervention period. Exact exercise selection, progression rules, sets, repetitions and load parameters were detailed in the full protocol; those specifics were not provided in the article summary.
The pilot’s primary clinical outcomes are performance-based mobility measures: the comfortable and fast Timed Up and Go tests. Additional clinical assessments and questionnaires will be administered at baseline, immediately post-intervention and at an 8-week follow-up to evaluate changes in mobility, muscle function and patient-reported outcomes. The short article did not list all secondary outcomes or the complete battery of assessments.
The central aim of this pilot trial is to evaluate feasibility across three domains:
Process feasibility: metrics such as recruitment, randomisation procedures and blinding of assessors.
Resource feasibility: operational considerations including assessor time and burden.
Scientific feasibility: safety monitoring and incidence of adverse events.
Feasibility will be judged against pre-specified a priori criteria for acceptance, which were set by the investigators and described in the full protocol; the summary did not provide the numerical thresholds for those criteria.
Participants will be assessed at three time points: baseline (pre-intervention), immediately after the 10-week intervention (post-intervention), and at an 8-week follow-up. Primary mobility outcomes (comfortable and fast Timed Up and Go) and questionnaires will be collected at each time point. The summary did not provide a detailed schedule for all secondary outcome measurements.
The trial received ethical approval from both participating institutions: Hamilton Integrated Research Ethics Board (reference #18235) and the University of British Columbia Clinical Research Ethics Board (reference #H25-00325). The study is registered with ClinicalTrials.gov (NCT06780995). Trial results will be published and shared with local stroke recovery groups, clinicians and researchers in the investigators’ network to inform a potential fully scaled trial.
This pilot RCT will test whether a structured, periodised power training programme (POWER) is feasible to deliver and evaluate compared with conventional resistance training (STRENGTH) in community-dwelling adults at least 6 months after mild to moderate stroke. The study focuses on feasibility metrics to determine whether to proceed to a larger definitive trial and uses functional mobility outcomes (Timed Up and Go tests) to capture clinically relevant changes in mobility.