None listed
Conditions
Brief summary
Our research has identified that many stroke survivors have poorly managed risk factors after stroke and many report ‘unmet needs’. To address these issues, we hypothesise that a cardiac rehabilitation program adapted for stroke survivors can improve secondary prevention of cardiovascular disease. Cardiac rehabilitation programs include exercise to increase cardiorespiratory fitness and educate people on ways to manage their health to prevent further cardiac events. These programs are known to reduce recurrent cardiac events in a cost-effective way. The specific aim is to run a pilot study of an adapted cardiac rehabilitation program in a group of stroke patients to examine its feasibility, acceptability and effect on cardiovascular risk factors and health-related quality of life. The program to be piloted takes into account the feedback from this broad range of stakeholders. The co-designed program will run for 7 weeks. It will include 1 hour of group exercise that can be adapted to suit different levels of function using a combination of standing and seated exercises with addition of light resistance, if appropriate. Following the exercise training, group-based discussion around a variety of topics will be led by a nurse facilitator with expert input into the content from physiotherapists, exercise physiologists, nutritionists and pharmacists. The exercise program will be designed and monitored by exercise physiologists and physiotherapists. The program will leverage off existing resources developed by the Stroke Foundation for stroke survivors and link into their existing online support systems to increase the maintenance of the program for participants. We will run 2 groups of 5 people per group in the first half of 2019. The study includes baseline assessment, program delivery for 2 hours per week for 7 weeks, a 1 week follow-up assessment and a 6 week follow-up assessment.
Interventions
The intervention is a 7 week program for 2 hours per week including 1 hour of education and 1 hour of exercise in a group setting. The program will be delivered in a group setting face to face at a clinical research facility. The program will be delivered by an experienced aged-care nurse, physiotherapist with expertise in stroke and exercise physiologist.
The nurse will facilitate the 1 hour group-based education component of the program. Materials for the group discussion will be based on tho
The intervention is a 7 week program for 2 hours per week including 1 hour of education and 1 hour of exercise in a group setting. The program will be delivered in a group setting face to face at a clinical research facility. The program will be delivered by an experienced aged-care nurse, physiotherapist with expertise in stroke and exercise physiologist. The nurse will facilitate the 1 hour group-based education component of the program. Materials for the group discussion will be based on those developed by the Stroke Foundation. There will be 7 topics including: (1) life after stroke, (2) risk factors for stroke, (3) medications, (4) mental health, (5) getting back to everyday activities, (6) relationships after stroke, and (7) memory and thinking. The exercise component will be led by a physiotherapise and an exercise physiologist. Each exercise session will comprise a 15 minute warm up followed by a 30 minute low to moderate intensity exercise circuit with at 15 minute cool down. The circuit will comprise different exercise modalities, both aerobic and resistance in nature that target different parts of the body. All exercises will be able to be completed standing or seated to allow for different levels of function of participants. There will be exercises with optional weight components to increase the intensity, if appropriate. The program will align with international recommendations on the best practice for exercise programs after stroke. Each participant will be prescribed the intensity of exercise appropriate for their fitness and health before the program. The intensity of all exercise completed in the circuit will be monitored closely using a combination of heart rate data (obtained from participant worn heart rate monitors) and self-reported exertion using the Borg Rating of Perceived Exertion scale. Exercise intensity will be increased if the participant is not meeting the prescribed intensity or will be ceased or adjusted if the participant is exceeding the pre-specified intensity range. Adherence to the program will be monitored through marking attendance at each education and exercise session by the study nurse/exercise physiologist/physiotherapist. In addition, participant satisfaction with the program will be assessed at the completion of the program with the Physical Activity Enjoyment Scale, 3 questions on program satisfaction recommended by the Consumer Assessment of Health Care Providers and Systems and 3 questions regarding the participant's opinion of the program impact.
Sponsors
University of Tasmania
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
The inclusion criteria for people with stroke are: 1. The person has suffered a stroke and been treated at the Royal Hobart Hospital 2. The person has been discharged either from (a) acute care to home or (b) from rehabiliation to home. The inclusion criteria for support people is: 1. The person is a carer or support person for a participant in the program 2. The support person consents to participate in the education component of the program
Exclusion criteria
The exclusion criteria for people with stroke in the study are: 1. Moderate or severe dementia (Telephone Interview for Cognitive Status–Modified scores lower than 19 of 50) 2. Medically unstable and unable to participate in either seated or standing light to moderate physical activity, as determined by medical professionals The exclusion criteria for support people in the program is: 1. Moderate or severe dementia (Telephone Interview for Cognitive Status–Modified scores lower than 19 of 50)
Outcome results
None listed