Promoting Physical Activity After Stroke Via Self-management

Federal University of Minas Gerais

Status: Completed

Conditions: Stroke

Treatments: Behavioral: Home-based self-management exercise program

Study type: Interventional

Funder types: Other

Identifiers

NCT05461976

65672517.6.0000.5149

Details and patient eligibility

About

Practising physical activity after a stroke is essential for the secondary prevention of stroke. However, the major individuals after stroke are sedentary. Individuals after stroke with mild disabilities could have fewer barriers to this practice. Thus, finding ways to promote physical activity after stroke in these individuals is important for them and public health. Interventions that consider behaviour change strategies are a good way to change a habit and could improve physical activity levels. Self-management interventions have been used to promote behaviour change in the stroke population.

The aim of this pilot trial will be to determine the efficacy of a self-management program to increase physical activity levels in stroke survivors with mild disability through 6 home-based sessions of self-management exercise over 3 and 6 months in a low-income country. Our secondary aims are to evaluate the effect of a self-management program on walking, exercise self-efficacy, participation, quality of life, depression and cardiovascular risks after 3 and 6 months.

Full description

One-quarter of stroke events in the world are recurrent. Stroke secondary prevention is essential for this population and health politics. The practice of a physical activity is a good option to reduce the chance to develop a second stroke. Self-management interventions have been used in the stroke population to increase physical activity. However, a review showed that the efficacy of this intervention to improve physical activity is inconclusive. Recently, a study of feasibility made in Brazil about the self-management approach showed positive results in this intervention to increase physical activity after stroke survivors with mild impairment. In addition, the results can be more beneficial for sedentary individuals. The aim of this study will be to test the efficacy of a home-based self-management exercise intervention to improve physical activity levels in sedentary individuals with a mild disability after stroke. The specific questions are:

In sedentary individuals with a mild disability after stroke,

1. Is a home-based self-management exercise effective in improving physical activity effective at increasing the number of steps taken per day?
2. Does any improvement in physical activity carry over to improvements in cardiovascular risk, walking ability, depressive symptoms, exercise self-efficacy, social participation and quality of life?

Enrollment: 24 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• time since stroke less than 6 months;
• ≥18 years of age;
• be able to walk 10 meters independently at a speed ≥ 0.8 m/s without any walk devices;
• had no cognitive impairments (determined by the cut-off scores on the Brazilian version of the Mini-Mental State Examination);
• be sedentary (steps counts less than 5000 steps/day).

Exclusion criteria

• have other neurological diseases (e.g. Parkinson, Multiple Sclerosis);
• had comprehensive aphasia (evaluated by simple motor command: "lift your good arm and raise your hand");
• have any other conditions that would prevent participation.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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24 participants in 2 patient groups

Home-based self-management exercise program

Experimental group

Description:

A home-based self-management exercise program will be implemented based on behaviour change techniques on the approach of Social-Cognitive Theory and Control Theory. In the present study, we will use the following behaviour changes techniques: health consequences, action planning, graded tasks, problem-solving/coping planning, modelling of the behaviour, vicarious reinforcement and non-specific encouragement, feedback on behaviour, self-monitoring on behaviour, review behaviour goals and goal setting (behaviour). The program will include six sessions of self-management with an average duration of 60 minutes. The intervention will be delivered individually and face-to-face in the participant's home by a physical therapist over 10 weeks.

Treatment:

Behavioral: Home-based self-management exercise program

Control Group

No Intervention group

Description:

This group will receive one session about education on risk factors after stroke and usual care.