Stepping up Aerobic Exercise to Improve Health Outcomes After Stroke

NCT02296268 | Completed

• 1 other identifier: CDHA-RS 2015-223
• Study Type: observational
• Target: 62
• Locations: 1 country
• Sites: 1

Brief Summary

Stroke is a leading cause of chronic disability here in Nova Scotia and globally. Aerobic exercise is known to improve health by increasing energy levels, physical mobility, balance, bone health, cardiovascular risk reduction, mental well-being, cognition, sleep, and quality of life. Nonetheless, people remain woefully inactive after stroke, regardless if they are in hospital or at home. The current investigative team and others have shown that even during physiotherapy, exercise intensity is not adequate to increase physical fitness. Consequently, patients are often deprived of a treatment that could improve their recovery. Why does this gap between evidence and clinical practice persist? Through a national survey the current team found that an important contributing factor is lack of appropriate screening (especially stress tests) to ensure that patients are safe to engage in aerobic exercise. This project is designed to close this evidence-practice gap by establishing a state-of-the-art aerobic exercise screening and prescription clinic at the Nova Scotia Rehabilitation Centre (NSRC). The intent is to compare outcomes of stroke rehabilitation participants before and after the clinic is underway and determine if the clinic has a positive effect on the confidence of NSRC physiotherapists to use aerobic exercise safely and effectively in stroke rehabilitation.

Conditions

Stroke

Keywords

stroke; aerobic exercise; screening; prescription

Outcome Measures

Primary Outcomes (1)

• Change from admission 6-Minute Walk Test at discharge

  To assess change between admission and discharge in distance walked without manual support in 6 minutes

  admission and discharge (baseline and 5-6 weeks later)

Secondary Outcomes (6)

• Change from admission 10-Meter Walk at discharge

  admission and discharge (baseline and ~5-6 weeks later)

• Change from admission resting blood pressure at discharge

  admission and discharge (baseline and 5-6 weeks later)

• Change from admission abdominal girth at discharge

  admission and discharge

• Change from admission Stroke-Specific Quality of Life at discharge

  admission and discharge (baseline and 5-6 weeks later)

• Change from admission Readiness for Physical Activity Scale at discharge

  admission and discharge (baseline and 5-6 weeks later)

Study Arms (3)

Pre-Clinic Stroke Group

In- or out-patients with diagnosis of ischemic or hemorrhagic stroke who have been referred to the NSRC prior to the establishment of the Clinic and are willing/able to provide written informed consent and have no contraindications to exercise testing. Utilization of aerobic exercise will be monitored during their physiotherapy sessions (Aim 3).

Behavioral: Aerobic Exercise Screening and Prescription Clinic

Post-Clinic Stroke Group

In- or out-patients with diagnosis of ischemic or hemorrhagic stroke who have been referred to the NSRC after the establishment of the Clinic and are willing/able to provide written informed consent and have no contraindications to exercise testing. Each patient will undergo an assessment in the Aerobics Clinic and will receive a prescription for aerobic training based on the assessment findings. Utilization of aerobic exercise will be monitored during their physiotherapy sessions (Aim 3).

Behavioral: Aerobic Exercise Screening and Prescription Clinic

Stroke Rehabilitation Physiotherapists

Physiotherapists whose current practice involves working full-time or part-time on in- or out-patient stroke service at the NSRC. Their self-efficacy regarding the clinical utilization of aerobic exercise post-stroke will be conducted prior to, and after, implementation of the Aerobics Clinic.

Interventions

Aerobic Exercise Screening and Prescription Clinic BEHAVIORAL

Patients will be referred to the Clinic by their physiotherapist to be assessed regarding their safety and readiness to participate in aerobic training. If they are deemed to be safe and ready, an aerobic exercise prescription will be written to guide the implementation of a safe and effective training protocol. Patients deemed to be at moderate to high risk will need to be cleared for testing by a physician on the stroke service. A cardiologist will be consulted about specific concerns re cardiac status.

Post-Clinic Stroke Group; Pre-Clinic Stroke Group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients post-stroke

You may qualify if:

• Male or female adults
• Diagnosed with ischemic or hemorrhagic stroke
• Referred to NSRC for stroke rehabilitation

You may not qualify if:

• Have contraindications to exercise testing using American College of Sports Medicine guidelines

Sponsors & Collaborators

• Nova Scotia Health Authority: lead

Study Sites (1)

QEII Health Sciences Centre

Halifax, Nova Scotia, B3H3J5, Canada

Location

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Affiliated Scientist

Study Record Dates

• First Submitted: November 14, 2014
• First Posted: November 20, 2014
• Study Start: January 30, 2016
• Primary Completion: January 26, 2018
• Study Completion: January 26, 2018
• Last Updated: March 23, 2018

Record last verified: 2018-03

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)