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Item type: Original item

Received: 24-01-2026

Accepted: 16-03-2026

Methodological alternative for Community Physical Activity

teachers in the rehabilitation of adults with neurological

sequelae.

Authors:

Yanelsy

Merino

Ruz¹*,

Sandra

Banguela

Beuvides²

and

Lourdes

de

Guadalupe

Rodríguez Pérez

3

¹Bachelor's

degree

in

Physical

Culture.

Specialist

teacher

of

Community

Physical

Activity.

“Aurelio

Janet

Torres”

Sports

Complex.

National

Institute

of

Sports,

Physical

Education

and

Recreation

(INDER).

Santa

Clara,

Villa

Clara,

Cuba,

mail:

yanelsymerinoruz@gmail.com

;

ORCID:

https://orcid.org/0009-0000-9901-3060

²Bachelor

of

Science

in

Physical

Culture.

Master

of

Science.

Assistant

Professor.

Central

University “Marta Abreu” of Las Villas. Faculty of Physical Culture.

Villa Clara, Cuba, mail:

sbanguela@uclv.cu

; ORCID:

https://orcid.org/0000-0002-1871-2570

3

Doctor of Science in Pedagogical Sciences. Full Professor, Central University “Marta Abreu” of

Las Villas. Faculty of Physical Culture.

Villa Clara, Cuba, mail:

lorperez@uclv.edu.cu

;

ORCID:

https://orcid.org/0000-0003-1417-8064

* Corresponding author:

yanelsymerinoruz@gmail.com

Abstract

This

study

designs

a

methodological

alternative

for

the

continuous

pedagogical

training

of

Community Physical Activity (CPA) teachers in the rehabilitation of adults with stroke sequelae

using the biosaludable gym at the Aurelio Janet Sports Complex in Santa Clara, Cuba. Adopting

a

socio-critical

paradigm

and

a

mixed-methods

approach,

the

needs

of

10

teachers

were

diagnosed through surveys, interviews, observations and documentary analysis. Results revealed

Universidad Central “Marta Abreu” de Las Villas

Facultad de Cultura Física

http://revistaciaf.uclv.edu.cu

Ciencia y Actividad Física

Vol.13,, 2026

ISSN: 2412-3226

RNPS: 2404

Pág. 34-44

34

significant

deficiencies

in

the

cognitive,

methodological

and

especially

biosaludable-safety

dimensions (70 % at a very low level), with favorable attitudes. Based on these findings, a four-

component

structured

alternative

was

elaborated:

teacher

training

and

education

(six

theoretical-practical

modules),

patient

functional

assessment

and

diagnosis,

physical

intervention

in

the

biosaludable

gym

(60-minute

sessions),

and

family/caregiver

work.

The

assessment by 12 specialists was with the criteria of

“Very adequate” and “Adequate” ratings

across

all

indicators

(relevance,

coherence,

feasibility,

novelty,

impact

and

generalizability),

confirming that the proposal is a viable and pertinent tool to enhance professional training and

the quality of life of adults with neurological sequelae in Cuban community settings

Keywords:

continuous pedagogical training; Community Physical Activity; stroke; biosaludable

gym; neurorehabilitation

Introduction

Disability is one of the highest public health challenges globally. According to the World Health

Organization

(WHO,

2023),

more

than

1.3

billion

people

worldwide

live

with

some

form

of

significant

disability.

Among

the

most

relevant

causes

are

neurological

conditions,

which

represent the leading cause of ill health and disability worldwide (The Lancet Neurology, 2024).

Stroke, also known as a cerebral hemorrhage, is a major health concern. It is the second leading

cause of death and the leading cause of long-term disability in adults worldwide (World Stroke

Organization, 2022). Each year, approximately 15 million people worldwide suffer a stroke, of

whom about 5 million die and 30% are left with permanent disability.

In Cuba, cerebrovascular diseases consistently rank among the top three causes of death and are

the leading cause of disability in adults. In 2023, an estimated 30,000 new cases of stroke were

reported,

with

a

mortality

rate

of

approximately

25-26%.

The

most

frequent

sequela

is

hemiplegia or hemiparesis,

characterized by paralysis or muscle weakness

on one side of the

body, accompanied by spasticity, balance problems, ataxia, and cognitive deficits, resulting in

functional dependence and a significant burden on families and the healthcare system.

Universidad Central “Marta Abreu” de Las Villas

Facultad de Cultura Física

http://revistaciaf.uclv.edu.cu

Ciencia y Actividad Física

Vol.13,, 2026

ISSN: 2412-3226

RNPS: 2404

Pág. 34-44

35

Neurological rehabilitation following a stroke is based on brain neuroplasticity. However, the

chronic

phase

is

often

interrupted

upon

hospital

discharge

due

to

limited

resources

and

continuous access to specialized therapies. This is where Community Physical Activity (CPA)

becomes relevant, a strategic component of the National Health System and the National Institute

of Sports, Physical Education, and Recreation (INDER). Among its programs, the bio-healthy

gyms

stand

out

—

public

spaces

equipped

with

mechanical

devices

that

allow

the

practice

of

kinesiotherapy and mechanotherapy outdoors.

At

the

Aurelio

Janet

Sports

Complex

in

Santa

Clara,

it

was

found

that

physical

activity

instructors

have

significant

gaps

in

their

knowledge

of

specific

neurological

conditions,

safe

prescription of adapted exercise, risk management, and adaptation of bio-healthy equipment to

the

sequelae

of

stroke.

This

situation

leads

to

empirical

or

superficial

interventions

that

limit

therapeutic benefit and can expose patients to unnecessary risks.

The scientific problem is formulated as follows: How to contribute to the continuous pedagogical

training

of

Community

Physical

Activity

teachers

for

the

physical

rehabilitation

of

adults

convalescing from strokes (CVA) in the biosaludable gym of the Aurelio Janet Sports Complex?

The overall objective is to design a methodological alternative for the continuous pedagogical

training

of

Community

Physical

Activity

teachers

in

the

physical

rehabilitation

of

adults

convalescent from stroke in the biosaludable gymnasium of the Aurelio Janet Sports Complex.

Methodology

The study was framed within a socio-critical paradigm and a mixed-research approach, with e

quantitave predominance. An applied research design was used, of a quasi-experimental pretest-

posttest type in a single group.

Population and sample.

Two

populations

were

worked:

the

first

made

up

by

the

10

Community

Physical

Activity

teachers

of

the

Aurelio

Janet

Sports

Complex

(graduates

in

Physical

Activity

and

Sports

Sciences, with more than three years of experience and access to bio-healthy spaces); the second,

Universidad Central “Marta Abreu” de Las Villas

Facultad de Cultura Física

http://revistaciaf.uclv.edu.cu

Ciencia y Actividad Física

Vol.13,, 2026

ISSN: 2412-3226

RNPS: 2404

Pág. 34-44

36

made up by12 specialists with more than 10 years of professional experience in Physical Culture,

neurological

rehabilitation,

Community

Physical

Activity

and

Public

Health

(three

of

them

directors of INDER linked to the AFC).

Methods and techniques.

Theoretical

methods (analytical-synthetic, inductive-deductive, historical-logical

and systemic-

structural-functional),

empirical

methods

(structured

survey,

semi-structured

interview,

structured

observation,

documentary

analysis

and

expert

criteria)

and

statistical

methods

(descriptive statistics) were used.

The survey diagnosed the level of preparedness in four dimensions: cognitive, methodological,

bio-health and safety, and attitudinal, using a Likert scale from 1 (very low) to 5 (very high).

Structured observation evaluated methodological performance in indicators such as selection of

functional exercises, suitability to the functional level, load dosage, postural control, technical

correction,

safety

measures,

communication,

and

session

organization

(scale:

Adequate

/

Moderately Adequate / Inadequate).

Research Stages.

Stage I (Diagnosis): characterization of the initial state of teacher preparation.

Stage

II

(Design):

elaboration

of

the

methodological

alternative

based

on

the

bio-healthy

approach.

Stage

III (Evaluation): assessment of effectiveness using expert criteria. Validity was ensured

through triangulation of methods, techniques, and instruments.

Results and discussion

Diagnosis Needs

The documentary analysis of the Methodological Indications for the 2025-2026 Course of the

Functional Department of Community Physical Activity and the guidelines for Bio-healthy gyms

showed

that,

although

they

create

the

regulatory

space

to

attend

to

this

population,

they

lack

Universidad Central “Marta Abreu” de Las Villas

Facultad de Cultura Física

http://revistaciaf.uclv.edu.cu

Ciencia y Actividad Física

Vol.13,, 2026

ISSN: 2412-3226

RNPS: 2404

Pág. 34-44

37

technical

specificity

(they

do

not

detail

exercises,

intensities,

contraindications

or

specific

progressions for neurological rehabilitation).

The results of the survey applied to the 10 teachers are summarized in Table 1.

Table 1. Percentage distribution of teachers according to level of preparation by dimensions

Level	Cognitive (%)	Methodological (%)	Bio-health and safety (%)	Attitudinal (%)
Very low	30.0	30.0	70.0	0.0
Low	20.0	30.0	20.0	0.0
Half	30.0	30.0	10.0	100.0
High	20.0	10.0	0.0	0.0
Very high	0.0	0.0	0.0	0.0

Note. Prepared by the author based on the results of the survey (n = 10).

The bio-health and safety dimension was the most compromised (70% at a very low level). The

cognitive dimension showed fragmented knowledge. The methodological dimension presented

deficiencies in planning and pacing. In contrast, the attitudinal dimension placed 100% of the

teachers at the medium level, reflecting a positive disposition.

Observation of 10 activities confirmed these findings (Table 2).

A moderately

adequate level

predominated in most indicators. The best-rated was communication and interpersonal skills (six

adequate

activities).

Difficulties

persisted

in

the

selection

of

functional

exercises

and

in

the

application of safety measures.

Table 2. Results of the structured observation of the activities (n = 10)

Indicator	Appropriate	Moderately adequate	Inappropriate
Selection of functional exercises	4	4	2
Suitability to the functional level	3	4	3
Load dosage	3	4	3
Postural control and balance	4	5	1
Technical correction	3	4	3
Implementation of security measures	3	4	3
Communication and human interaction	6	4	0
Session organization	4	4	2

Note: Prepared by the author based on the observation guide.

The

semi-structured

interview

profound

into

the

experiences

gained

using

the

bio-healthy

exercise equipment. Six out of ten professors (60%) reported using it in the care of patients with

other

pathologies

and

indicated

satisfactory

results

in

their

progress.

However,

they

also

discussed

the

difficulties

they

face

when

working

with

patients

with

neurological

sequelae,

including:

mobilization

and

gait,

complexities

of

clinical

diagnosis,

systematic

care,

and

Universidad Central “Marta Abreu” de Las Villas

Facultad de Cultura Física

http://revistaciaf.uclv.edu.cu

Ciencia y Actividad Física

Vol.13,, 2026

ISSN: 2412-3226

RNPS: 2404

Pág. 34-44

38

insufficient

preparation

to

undertake

the

task

safely.

The

professors

requested

training

on

the

characteristics

of

different

types

of

stroke

and

their

sequelae,

as

well

as

on

methodological

elements for planning and conducting therapy sessions.

Proposed methodological alternative

Based on the diagnosis, a methodological alternative was designed, structured in four interrelated

components:

Component

1.

Teacher

Training

and

Development.

Objective:

To

prepare

teachers

with

the

necessary theoretical, methodological, and practical foundations. It is structured in six modules

(44 total hours): (1) Neurological Foundations (8 hours); (2) Functional Assessment (6 hours);

(3) Exercise Methodology in Bio-Healthy Environments (12 hours); (4) Safety and First Aid (4

hours);

(5)

Communication

and

Motivation

(4

hours);

(6)

Supervised

Practice

(10

hours).

Methodology:

Theoretical

and

practical

workshops,

case

studies,

demonstrations,

on-site

supervision, and support materials.

Component

2.

Functional

Evaluation

and

Diagnosis.

Objective:

To

characterize

the

patient

in

order

to

establish

a

baseline,

identify

risks,

and

define

individualized

goals.

This

includes

an

initial interview (stroke history, comorbidities, medication, expectations) and the application of

adapted

tests:

6-minute

walk

test,

10-meter

walk

test,

abbreviated

Berg

Balance

Scale,

MRC

Strength Scale, Barthel Index, and fall risk assessment. Data is recorded on an individual chart

with reassessments every 4

–

6 weeks.

Component

3.

Physical

Intervention

in

the

Bio-Healthy

Area.

Objective:

to

implement

an

adapted

and

progressive

exercise

program.

Principles:

individualization,

progression,

safety,

functionality, variety, and active participation. Typical 60-minute session: warm-up (10-12 min),

main phase in a circuit of bio-healthy machines (30-35 min), cool-down (8-10 min), and closing

(5 min). Specific recommendations are considered according to the type of sequela (hemiparesis,

spasticity, ataxia, balance problems, and cognitive deficits).

Component

4.

Working

with

the

family

and

caregiver.

Objective:

To

empower

the

primary

caregiver to support the process, ensure safety at home, and promote continuity of care. Content:

Universidad Central “Marta Abreu” de Las Villas

Facultad de Cultura Física

http://revistaciaf.uclv.edu.cu

Ciencia y Actividad Física

Vol.13,, 2026

ISSN: 2412-3226

RNPS: 2404

Pág. 34-44

39

Basic information about stroke, safe transfer techniques, basic home exercises, warning signs,

and emotional support. Format: Group workshops (two two-hour sessions).

Assessment by expert criteria

The 12 specialists (three PhDs in Physical Culture Sciences, six Master's degree holders, and

three graduates, all with over 20 years of experience) assessed the indicators of relevance, clarity

and

comprehensibility

of

the

actions,

internal

coherence,

feasibility

of

application,

scientific

novelty,

potential

impact,

and

generalizability.

The