Title: Developing and piloting a behavioural, community-based intervention to increase walking among people with stroke
Funder: Department of Health (England)

Abstract: Background Many stroke survivors who are able to walk do not walk for long periods or lead sedentary lifestyles. Improved walking and greater walking endurance are valued by stroke survivors, due to their effects on community participation and fulfilment of valued social roles. Thus, developing stroke-specific interventions to promote walking is a key research goal. This goal’s relevance was confirmed in discussion with a local Stroke Research Patients & Family Group. Walking is sustainable, low cost, can take place locally and is not reliant on equipment or formal classes. Darker & French have developed a successful, psychologically informed intervention to increase walking among sedentary individuals. We want to adapt this behavioural intervention for use with stroke survivors. Aims The overall aim of the project is to adapt a behavioural walking intervention, of proven efficacy in healthy, sedentary people, to increase stroke survivors’ walking and social participation. The project will: 1) Use qualitative and quantitative methods to explore: a) the potential acceptability of the intervention, b) how stroke survivors’ beliefs about walking predict walking. This data will be used to adapt the intervention, increasing its acceptability and ensuring it targets the beliefs most important in increasing walking 2) Conduct a pilot controlled trial of the adapted intervention, assessing its feasibility and acceptability and providing initial estimates of its effects on walking and social participation. Plan of Investigation The South London Stroke Register (SLSR) will act as a sampling frame for a) qualitative interviews, exploring stroke survivors beliefs about walking and the intervention’s potential acceptability; b) a survey to assess which psychological constructs most strongly predict walking. These findings will be used to adapt a behavioural walking intervention of proven efficacy for use with stroke survivors. The adapted intervention’s potential efficacy compared to a usual care control group will be estimated in a pilot randomised controlled trial of participants recruited from the SLSR. Key outcomes are objectively measured walking and social participation immediately post-intervention, at 6 months and 12 months. Acceptability and feasibility will be assessed. Potential Impact This project will result in the development of an intervention to increase stroke survivors’ walking, which should help increase their participation in community and social activities, and improve their quality of life. This project will provide data to inform an application for funding for a full evaluation of the intervention in a randomised controlled trial. If the intervention is proven effective, it has the potential to become part of NHS care for stroke survivors who are able to walk outside at discharge. The intervention could be delivered by therapists, psychologists, nurses and other multidisciplinary team members, depending on local circumstances.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: STROKE