--- title: "Periodised Power Training (POWER) Pilot RCT Protocol for Chronic Stroke Recovery" id: "bmj-open-9-periodised-power-training-in-community-dwelling-adults-with-chronic-stroke-a" canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-9-periodised-power-training-in-community-dwelling-adults-with-chronic-stroke-a" content_type: "clinical_feed_article" specialty: "Neurology" source_name: "BMJ Open" source_url: "http://bmjopen.bmj.com/cgi/content/short/16/9/e126255?rss=1" published_at: "2026-09-18T12:04:55.000Z" evidence_level: "Journal Feed" license: "CC-BY-NC-4.0 / Informational Use" --- # Periodised Power Training (POWER) Pilot RCT Protocol for Chronic Stroke Recovery ## Provenance & Clinical Metadata - **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-9-periodised-power-training-in-community-dwelling-adults-with-chronic-stroke-a - **Specialty:** [Neurology](https://medichelpline.com/clinical-feed/neurology.md) - **Primary Source:** BMJ Open - **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/9/e126255?rss=1) - **Published At:** 2026-09-18T12:04:55.000Z - **Evidence Rating:** Journal Feed ## Executive GIST (TL;DR) - This article describes the protocol for the Power Exercise for Stroke Recovery (POWER) pilot multisite randomised controlled trial testing a **periodised power training** programme versus conventional resistance training in community-dwelling adults with chronic stroke. - The rationale: while resistance training (RT) can increase muscle strength after stroke, **muscle power** (ability to move quickly) may be more critical for preserving mobility; prior power-training trials lacked structured **periodisation** such as building strength before power phases. - The POWER intervention is a 10-week, thrice-weekly supervised RT programme with a 1-week familiarisation, an intense strength-building phase (weeks 2–5), then a power-focused phase (weeks 6–10). - The comparator (STRENGTH) is a 10-week, thrice-weekly, conventional moderate-intensity strength programme beginning after the 1-week familiarisation and continuing weeks 2–10, following current physical activity recommendations. - Sixty adults at least 6 months after mild to moderate stroke will be recruited across two Canadian sites (McMaster University and University of British Columbia) and randomised to POWER or STRENGTH. - The primary aim of this pilot is feasibility: process (randomisation, blinding), resources (assessor burden) and scientific feasibility (adverse events), evaluated against a priori acceptance criteria. - Clinical outcomes include primary mobility measures: **comfortable and fast Timed Up and Go** tests; assessments occur at baseline, post-intervention and 8-week follow-up. Additional questionnaires and clinical measures will be collected. - Ethical approval has been granted at both institutions (Hamilton Integrated Research Ethics Board #18235 and UBC Clinical Research Ethics Board #H25-00325). Trial registration: NCT06780995. - Trial findings will guide progression to a fully scaled trial and will be disseminated via publications and to stroke recovery groups, clinicians and researchers in the investigators’ network. ## Clinical Analysis & Structured Key Points Introduction Resistance training (RT) can improve muscle strength in people with stroke. However, muscle power may be more important than strength to preserve mobility after stroke. Power training (ie, RT with the intent to move as fast as possible) has shown to be feasible in people with stroke but trials to date were limited in their approaches to exercise prescription, namely providing minimal emphasis on periodisation strategies (eg, developing strength before power). We developed a periodised power training intervention, Power Exercise for Stroke Recovery (POWER), and recently showed that POWER was feasible and could improve muscle power, mobility and health-related quality of life in people with stroke. We propose the next stage in investigation - a pilot multisite randomised controlled trial to test the feasibility of the trial design before embarking on a fully scaled trial. Methods and analysis This study will be a pilot multisite randomised controlled trial conducted at McMaster University and the University of British Columbia in Canada. 60 people ≥6 months following mild to moderate stroke will be randomly allocated to one of two, thrice-weekly, 10-week RT interventions: (1) periodised power training intervention (POWER) or (2) conventional RT intervention following current physical activity recommendations (STRENGTH). Both training programmes begin with a 1-week familiarisation period consisting of low-intensity versions of the programmes. The POWER group will begin with an intense strength-building phase (weeks 2 - 5), followed by a power training phase (weeks 6 - 10). The STRENGTH group will engage in a moderate-intensity strength-building programme from weeks 2 - 10. The primary outcome of this trial is feasibility of the process (eg, randomisation, blinding), resources (eg, assessor burden) and scientific feasibility (eg, adverse events), using a priori criteria for acceptance. Clinical outcomes (primary: comfortable and fast Timed Up and Go Tests) and questionnaires will be assessed at baseline, post-intervention and 8-week follow-up. Ethics and dissemination This trial has received ethical approval at both institutions (Hamilton Integrated Research Ethics Board #18235, University of British Columbia Clinical Research Ethics Board #H25-00325). Trial results will be published and made available to local stroke recovery groups, clinicians and researchers in our network. 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