Please select the eligibility criteria that correspond to the clinical trial below.
Title: N/A
Brief Summary: Summary

This study will look at physical exercise after acute ischaemic stroke. It is called the ExStroke Pilot Trial.

Physical activity is associated with a lower risk of first-time stroke. It remains unknown if physical activity also is associated with a lower risk of recurrent stroke. Patients with ischaemic stroke have a 30% to 40% risk of a recurrent stroke during a 5 year follow-up. The risk of acute myocardial infarction (MI) and death from vascular disease is approximately 15% each. The impact of lifestyle factors on risk for these events is insufficiently covered in the international scientific literature.

Purpose:

The purpose of the trial is to examine whether the level of physical activity increases in patients who have had an ischemic stroke, when they are informed about physical activity and instructed in a physical training program. The occurrence of new cerebro- and cardiovascular events in the patients will be registered. The patients are randomised to receive oral and written information by a physician and a physiotherapist about physical exercise; or to a control group with no instruction regarding physical exercise. Both groups will receive the best available therapy with regard to secondary stroke prevention and will be informed about lifestyle factors.

Irrespective of which group the patients are randomised to, all patients will receive the best possible established treatment with regard to prevention of thromboses; blood pressure control; lipid lowering agents, if necessary; and information about diet, tobacco smoking, and vitamin supplements.

Study Design:

The patients will be randomised centrally within 90 days after stroke onset, and they will be re-examined at 3, 6, 9, 12, 18, and 24 months. Inclusion criteria are patients with ischaemic stroke, aged 40 years or older. In the pilot trial a number of 300 included patients is wanted.


Options:
A: Inclusion Criteria:

* Age ≥ 18 years
* Hospitalized due to ischemic stroke\* or intercurrent ischemic stroke\* event within the past 30 days OR Transient ischemic attack, confirmed by stroke neurologist.
* Atherogenic etiology(large vessel, small vessel, cryptogenic with at least one stroke risk factor, or embolic stroke due to atherogenic cardiac disease) as defined by TOAST criteria.
* Community dwelling prior to stroke
* Resides within the District of Columbia or closely nearby (preferably within 10 miles of the DC border)
* Expected to reside within the District of Columbia or closely nearby (preferably within 10 miles of DC border)
* Caregiver or interested party available, if moderately or severely disabled (not required to actually reside with participant)
* Sufficient number of collateral contacts to assure follow-up. Defined as: Preferred: at least 6 contacts; and No fewer than 3 contacts (unless approved by study PI/co-PI/co-I)
* Judged likely to return to community setting at completion of post-acute care.

Exclusion Criteria:

* Non-atherogenic cause of stroke
* NIHSS \> 20
* Any medical condition that would limit participation in follow up assessments
* Baseline dementia per informant report (AD8) or screening assessment (Short Blessed Memory Orientation Concentration Test)
B: Inclusion Criteria:

* Patients of LAC+USC, Rancho Los Amigos, Olive View-UCLA, or Harbor-UCLA
* Patients who have had an acute transient ischemic attack (TIA) or ischemic stroke or carotid procedure within the last six months
* English or Spanish speaking
* At least 40 years of age
* Capable of giving informed consent (no proxies will be used to obtain consent)
* Blood pressure not optimally controlled (\>120/80, at least 72 hours post-stroke)

Exclusion Criteria:

* Age 39 years or younger
* Hemorrhagic stroke
* Patients with severe global disability which would preclude him/her from participating in group clinics
* Patients with advanced dementia
C: Inclusion Criteria:

* Males and females
* Over 17 years of age.
* Diagnosis of first probable or definite TIA or non-disabling stroke (National Institutes of Health Stroke Scale \< 6)
* Post-event interval of \<90 days.
* Residence within 75 km of intervention site.
* Orientation to time, place and person and ability to follow simple 3-step commands.
* Ability and willingness to provide informed consent.

Exclusion Criteria:

* Evidence of intracranial hemorrhage on MRI or CT scan.
* Presence of contraindications to exercise testing and training, in accordance with American College of Sports Medicine Guidelines.
* Participation in another study that could potentially confound the outcomes of this trial.
D: Inclusion Criteria:

* Subjects aged 40 years or older.
* Patients with a clinical diagnosis of stroke; symptoms lasting 24 hours or more.
* Computed tomography (CT)-scan of the brain must either show a new infarct or be normal. Patients only with infarcts without clinical symptoms cannot be included.
* Inclusion shall take place before day 90 after stroke onset.
* Informed consent after verbal and written information.
* The patient must be able to walk either unaided or with a cane or a walker.

Exclusion Criteria:

* Patients who are unable to understand the information, or who cannot cooperate, are excluded.
* Patients confined to a wheelchair or bed.
* CT-scanning showing intracranial haemorrhage or focal pathology other than infarction, cerebral atrophy, or leucoaraiosis.
* Modified Rankin score of 4 or 5 before the actual stroke.
* Serious medical disease such as AIDS, metastatic cancer, or abnormalities that the investigator feels may compromise the patient's successful participation in the trial.
* Earlier randomisation in this trial.

Answer: D