High‐Intensity Functional Activities Specific Training (FAST) in Post‐Stroke Rehabilitation: A Randomized Trial on Motor Recovery and Quality of Life Improvements

ABSTRACT Background Stroke often leads to long‐term disability, impacting motor function, mobility, and quality of life. However, the effectiveness of different intensities of functional training in improving these outcomes in stroke rehabilitation is not well established. Purpose This study aimed to determine the effects of different intensities of functional activities specific training on upper extremity function, mobility, fall risk, and quality of life in stroke patients. Methods This randomized controlled trial was conducted in a rehabilitation setting (PRH Islamabad) with age 40–60 years and 3 months post‐stroke. Participants ( N = 99) were randomly (simple) assigned to conventional therapy, moderate‐intensity, or high‐intensity training with 33 in each group. Eligibility criteria included a Montreal Cognitive Assessment score of 18–25, Fugl‐Meyer Assessment score of 50–70 and a Modified Rankin Scale score of 3 and 4, suggesting moderate motor impairment and moderate to severe disability, respectively. Participants with severe spasticity, inability to follow two‐step commands, concurrent stroke treatments, other neurological conditions, and a history of falls were excluded. The 12‐week training program utilized the FAST‐Table, and outcomes including Fugl‐Meyer Assessment for upper extremity, Berg Balance Scale, and Stroke‐Specific Quality of Life Urdu scale—were assessed at baseline, 4, 8, and 12 weeks. Results The mean age of participants were 65.4 ± 7.2 years, gender (52% male, 48% female, ischemic 70%, and hemorrhagic 30%). The high‐intensity group showed significant improvements in Fugl‐Meyer Assessment‐Upper Extremity scores at weeks 8 and 12 ( p < 0.05), Timed Up and Go test ( p < 0.05), Berg Balance Scale scores ( p < 0.05), and Stroke‐Specific Quality of Life Urdu scale ( p < 0.05). Moderate‐intensity and conventional groups also showed improvements individually. Discussion High‐intensity functional training leads to greater improvements in physical performance and quality of life in stroke survivors compared with moderate‐intensity functional training and conventional therapies. Trial Registration: https://clinicaltrials.gov/ (NCT05158543)