Course Aim: The overall aim of this course is to enable Specialist Exercise Instructors and other suitably qualified staff (e.g. Physiotherapists) to design, implement and evaluate physical activity programmes for people after stroke that are safe, effective, appropriate and enjoyable, based on current evidence, and in accordance with the relevant clinical guidelines, national service frameworks, national occupational standards and educational standards.

Content: This 20-credit course at SCQF level 8 (comparable to BSc. (Hons) level 2), comprises a total of 200 hours of student work. This includes Pre-course learning on our training portal, lectures, tutorials and practical workshops. In terms of content, the course follows the patient journey from acute stroke through to rehabilitation and referral into an exercise referral scheme. It concentrates on the role of the specialist exercise instructor in assessing the person with stroke, designing and delivering exercise programmes, evaluating their effects, as well as working as a professional as part of a multidisciplinary team. Along the way, the following topics are covered: the pathology of stroke; the input of the multidisciplinary team in the management of stroke; fitness levels after stroke and its impact on function; evidence for physical activity after stroke and the impact of physical activity on risk factors in stroke; indications and contra-indications to exercise after stroke; clinical guidelines; the implications of co-morbidities and medications on exercise performance; motivation and communication strategies aimed at improving health behaviour; relevant professional standards pertaining to ethical issues including; confidentiality and risk management and national service frameworks.

The course theory examines the different types and causes of stroke, the impact, recovery and co-morbidities, stroke management services and secondary prevention, physical fitness after stroke, the effects of exercise after stroke, assessment and screening tools and referral guidelines. It discusses the role of the exercise professional, including effective communication, goal setting and motivational behaviour change techniques. Finally, it introduces service implementation and evaluation.

The course practical uses the evidence based exercises from the evidence based STARTER trial and theory from a recent Cochrane Review. Through workshops and case study it educates instructors to introduce, adapt, individually tailor and progress exercises according to the specific and differing needs of this patient/client group. Workshops include teaching in groups and on a one-to-one basis. The course content is delivered through lectures, practical workshops and self-guided learning. The tutor team on each course includes three experienced specialists in exercise after stroke: a consultant, a physiotherapist and an exercise instructor. You will meet the physiotherapist and exercise instructor on the face to face training and a specialist stroke consultant delivers the narrated power points on the online training portal.

Online Pre-course training: LLT have developed an online training portal designed to give more flexibility, reduce travel costs and time required off work and allow theory elements of the training to be completed in your own time. LLT are still committed to face to face/practical workshops and all these remain in place for your training, it is the theory elements that lend themselves well to self-directed learning that are available on the online portal for your convenience.

How will the online training portal work?

  • We will send by post the manuals you will need for the training
  • We will email you an enrolment key (password) to access some resources prior to attending the face to face training, so when you attend the training you would have learnt a lot about the EfS already which means we can really focus on your practical skills when we see you
  • Your pre-course and mid course online tasks will include; viewing narrated PowerPoints and videos, completion of MCQ quiz’s and submission online of short answer worksheets
  • All online tasks must be completed within the time frames specified. Online elements are mandatory and a requirement. Candidates not completing them will be putting themselves at a disadvantage and may find the face to face days challenging if they are not prepared for practical workshops and tasks.
  • Online tasks are monitored and supported by your LLT tutor and are required to be completed within allotted time frames to ensure you are fully prepared for each of the face to face training days.

Completion of the online elements will require you to have;

  • Access to computer & reliable internet
  • A minimum of 10 hours to read manuals, watch the PowerPoints and complete the pre-course online tasks prior to face to face training

Software and Hardware requirements for your use of the training portal: There are no hardware requirements. There are software requirements – the minimum browser version that can be used is: recent Google Chrome(30+), recent Mozilla Firefox(25+), Safari 6, Internet Explorer 9 or 10.

Face to face training: Following the online pre-course learning, the face to face training will focus on the leading and teaching skills of the EfS to prepare you for your practical assessment


Level 3 Exercise Referral


  • Evidence of current CPR proficiency must be brought to the assessments.
  • Candidates will take a 2 hour theory paper on Day 3.
  • A Session plan is to be submitted as a hard copy on Day 4 for marking.
  • On Day 4, candidates will teach and self-evaluate their teaching of an exercise after stroke group and one-to-one exercise session. This will include a warm up, followed by functional and strength exercises taught in a circuit, in a group and on a one-to-one basis, and flexibility exercises taught in a cool down. Particular emphasis will be placed on specific adaptations and progressions. A minimum of 40 minutes of teaching will be observed and assessed.
  • Candidates will finally complete a Case Study on a patient after stroke, following viewing of a short film clip, and will be required to submit the written case study relating to this individual online 4 weeks after assessment day.

Awarding Organisation:

Endorsed by PD:Approval for REPs recognition