Conclusions Stroke secondary prevention lifestyle interventions are effective in terms of affecting positive change in relation to lifestyle behaviours , physiological and secondary outcomes .
However , there was insufficient evidence to determine the effect of intervention on incidence of stroke recurrence .
EXECUTIVE SUMMARY Background Each year , approximately 15 million people worldwide have a stroke ; of these , five million die and another five million are chronically disabled .
Stroke recurs in approximately 25 % of patients during the first five years post-stroke ; recurrence may result in death , increased disability or institutionalisation .
Modifiable risk factors for recurrent stroke have been identified , and may be addressed by means of behavioural health promotion interventions .
Objectives This systematic review sought to establish the effectiveness of secondary prevention behavioural interventions , which address one or more modifiable lifestyle risk factors for recurrent stroke i.e. tobacco use , unhealthy diet , physical inactivity and excessive alcohol consumption .
Time frame and predictors of recovery from disability following recurrent ischemic stroke
Objective : To assess the rate , degree , and predictors of recovery from a disabled to nondisabled state in patients disabled after recurrent ischemic stroke . Methods : Patients with ischemic stroke enrolled in the Management of Atherothrombosis with Clopidogrel in High Risk Patients ( MATCH ) Study underwent prospect i ve assessment of their modified Rankin score ( mRS ) at 1 , 3 , 6 , 12 , and 18 months after enrollment and after recurrent stroke . Patients disabled ( defined as mRS ≥ 3 ) after recurrence were analyzed for recovery ( defined as mRS < 3 ) during the 18 months , and predictors of recovery were sought using a Cox proportional-hazard multiple regression analysis . Results : Three hundred forty-five ( 54 % ) of 637 patients were disabled after recurrent ischemic stroke ; 115 ( 33 % ) patients had been disabled and 230 ( 66 % ) nondisabled before stroke recurrence . At recurrence , the degree of disability was moderate ( mRS 3 ) in 135 ( 39 % ) patients , severe ( mRS 4 ) in 139 ( 40 % ) , and very severe ( mRS 5 ) in 71 ( 21 % ) . After 12 months ' median follow-up , 117 ( 34 % , 95 % CI : 29 to 39 % ) had recovered : 68 ( 50 % , 42 to 59 % ) of 135 moderately disabled , 45 ( 32 % , 25 to 41 % ) of 139 severely disabled , and 4 ( 6 % , 2 to 14 % ) of 71 very severely disabled ; 70 ( 20.3 % ) patients died . From recurrence , median time to recovery was 6 months ( mRS 3 ) and 18 months ( mRS 4 ) ; 94 % with very severe disability had not recovered at 18 months . Independent predictors of recovery were moderate disability at recurrence ( mRS 3 ) compared with severe ( mRS 4 : hazard ratio [ HR ] 1.5 ; 95 % CI 1.04 to 2.3 ) or very severe disability ( mRS 5 : HR 7.6 ; 2.7 to 20 ) and a nondisabled vs disabled state before recurrence ( HR 4.0 ; 2.3 to 6.8 ) . Conclusions : The rate of recovery from recurrent ischemic stroke was greatest in the first 6 months ; one-third of patients recovered within 12 months . The significant predictors of recovery were a nondisabled state before recurrence and increasing severity of the recurrent stroke
Conclusions Stroke secondary prevention lifestyle interventions are effective in terms of affecting positive change in relation to lifestyle behaviours , physiological and secondary outcomes .
However , there was insufficient evidence to determine the effect of intervention on incidence of stroke recurrence .
EXECUTIVE SUMMARY Background Each year , approximately 15 million people worldwide have a stroke ; of these , five million die and another five million are chronically disabled .
Stroke recurs in approximately 25 % of patients during the first five years post-stroke ; recurrence may result in death , increased disability or institutionalisation .
Modifiable risk factors for recurrent stroke have been identified , and may be addressed by means of behavioural health promotion interventions .
Objectives This systematic review sought to establish the effectiveness of secondary prevention behavioural interventions , which address one or more modifiable lifestyle risk factors for recurrent stroke i.e. tobacco use , unhealthy diet , physical inactivity and excessive alcohol consumption .