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Secondary prevention of stroke. A telehealth-delivered physical activity and diet pilot randomized trial
Coralie English1,2,3, Emily R Ramage1,4, John Attia5,6
1School of Health Sciences, University of Newcastle, Newcastle, NSW, Australia.
Background:
Improving physical activity levels and diet quality are important for secondary stroke prevention.
Aim:
To test the feasibility and safety of 6-month, co-designed telehealth-delivered interventions to increase physical activity and improve diet quality.
Methods:
A 2 × 2 factorial trial (physical activity (PA); diet (DIET); PA + DIET; control) randomized, open-label, blinded endpoint trial. Primary outcomes were feasibility and safety. Secondary outcomes included stroke risk factors (blood pressure, self-report PA (International Physical Activity Questionnaire (IPAQ)) and diet quality (Australian Recommended Food Score (ARFS)), and quality of life. Between-group differences were analyzed using linear-mixed models.
Results:
Over 23 months, 99 people were screened for participation and 40 (40%) randomized (3 months to 10 years post-stroke, mean age 59 (16) years). Six participants withdrew, and an additional five were lost to follow-up. Fifteen serious adverse events were reported, but none were deemed definitely or probably related to the intervention. Median attendance was 32 (of 36) PA sessions and 9 (of 10) DIET sessions. The proportion of missing primary outcome data (blood pressure) was 3% at 3 months, 11% at 6 months, and 14% at 12 months. Between-group 95% confidence intervals showed promising, clinically relevant differences in support of the interventions across the range of PA, diet quality, and blood pressure outcomes.
Conclusion:
Our telehealth PA and diet interventions were safe and feasible and may have led to significant behavior change.
Trial Registration:
ACTRN12620000189921.
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