A mobility booster program (HiWalk) in long-term community stroke rehabilitation

Participants will receive the HiWalk program for 3 weeks (up to 3 hours a day, five days a week, totaling 45 hours). The HiWalk program consists of an individually tailored motor training program (strength, balance and task training) and specific mobility practice. Some more specific examples include, within strength training participants will complete strengthening exercises of the lower limbs. For mobility practice walking overground or on a treadmill will be practiced, including negotiating obstacles. Embedded throughout the program is a self-management approach. Participants are guided through the Taking Charge program and set individualised mobility goals. Taking charge is a workbook that asks the individual to reflect on their strengths and challenges and identify the next steps in their recovery journey. A standardised program assessment identifies the individual program for each participant. The exercise component is delivered as a small group (4-5 participants, 1 facilitator). Each participant's program is reviewed weekly to ensure it remains suitable and is progressed in difficulty as appropriate. If outside of the HiWalk weeks participants usually access therapy they will continue to participate in their usual therapy program which may or may not include physiotherapy. The HiWalk program is led by a physiotherapist and sessions are facilitated by a physiotherapist, exercise physiologist or allied health assistant/student. Sessions are completed face-to-face in a community rehabilitation gym. Most sessions are completed as a small group (4-5 people). The program assessment and weekly review are completed one-to-one between each participant and a program therapist. Each activity within the program has individualised plans developed with the therapist and the participant. Each activity has pre-planned levels of difficulty and modifications that may be enacted in order to individualise the activity to the participants ability. Adherence to the intervention will be recorded as session attendance (proportion of program sessions attended) and session participation (time attended and exercise repetitions completed).