The overall best evidence syntheses showed moderate quality evidence that lifestyle interventions do not lead to significant improvements in the physical activity level of people with stroke or TIA .
There is low quality evidence that lifestyle interventions that specifically target physical activity are effective at improving the levels of physical activity of people with stroke or TIA .
Based on the results of this review , general lifestyle interventions on their own seem insufficient in improving physical activity levels after stroke or TIA .
Lifestyle interventions that specifically encourage increasing physical activity may be more effective .
Insufficient amounts of physical activity is a risk factor for ( recurrent ) stroke .
People with a stroke or transient ischemic attack ( TIA ) have a high risk of recurrent stroke and have lower levels of physical activity than their healthy peers .
Though several review s have looked at the effects of lifestyle interventions on a number of risk factors of recurrent stroke , the effectiveness of these interventions to increase the amounts of physical activity performed by people with stroke or TIA are still unclear .
Therefore , the research question of this study was : what is the effect of lifestyle interventions on the level of physical activity performed by people with stroke or TIA ?
Utility of a Post-Hospitalization Stroke Prevention Program Managed by Nurses
Abstract Goal : Evidence -based guidelines exist for the prevention and treatment of patients with cerebral ischemia . Despite these guidelines , there are gaps in clinical practice . Our study aim ed to determine if a physician-directed , nurse-case-management program could reduce individual patient vascular risk factors . Methods : Patients hospitalized with atherosclerotic cerebral ischemia with ≥ 1 major uncontrolled risk factor for stroke ( hypertension , tobacco use , dyslipidemia , diabetes ) were eligible to enroll in our study . Patients were r and omized to management by the nurse-prevention program or usual care .  Patients in the usual-care group received their initial risk-factor assessment and a scheduled follow-up at 1 year . Patients in the usual-care group underwent further follow-up by primary care and /or neurology as recommended during their hospitalization or outpatient visit . Patients assigned to the prevention group received individualized education , motivational interviewing , and were aided in setting up their risk-factor modification goal plan . Additional education was tailored to each patient based on individualized risk factors . Prevention-group patients also underwent consultation with a registered dietitian and an exercise physiologist . The primary endpoint of the study was improvement of ≥ 1 major patient risk factor for occurrence of stroke to goal at 1 year . Results : At 1-year post-hospitalization , patients in the nurse-care-management group were 42 % more likely to have met the primary endpoint ( n = 18 ; 61 % nurse-managed patients ) compared with 33 % ( n = 18 ) of patients undergoing usual care ( P = 0.09 ) . There was no significant reduction in minor risk factors for either patient group . Patients in the prevention group had greater reductions in low-density lipoprotein cholesterol levels ( −38 vs −4 ; P = 0.0083 ) , changes in cardiovascular risk score ( −5.2 vs 1.3 ; P = 0.0033 ) , and had a greater reductions in systolic blood pressure ( −12.2 vs −0.105 ; P = 0.07 ) than their usual-care counterparts ( changes shown respectively ) . Patients in the prevention group were more likely to follow a prescribed diet than those in the usual-care group ( 50 % ) vs 7 % , respectively ; P = 0.0070 ) and maintain an exercise program ( 83 % vs 33 % , respectively ; P = 0.0018 ) . Summary : A physician-directed , nurse case-management system for patients post-hospitalization for cerebral ischemia is feasible and may help improve long-term control of major patient risk factors for stroke . A larger trial is needed to verify trends noted in our study
The overall best evidence syntheses showed moderate quality evidence that lifestyle interventions do not lead to significant improvements in the physical activity level of people with stroke or TIA .
There is low quality evidence that lifestyle interventions that specifically target physical activity are effective at improving the levels of physical activity of people with stroke or TIA .
Based on the results of this review , general lifestyle interventions on their own seem insufficient in improving physical activity levels after stroke or TIA .
Lifestyle interventions that specifically encourage increasing physical activity may be more effective .
Insufficient amounts of physical activity is a risk factor for ( recurrent ) stroke .
People with a stroke or transient ischemic attack ( TIA ) have a high risk of recurrent stroke and have lower levels of physical activity than their healthy peers .
Though several review s have looked at the effects of lifestyle interventions on a number of risk factors of recurrent stroke , the effectiveness of these interventions to increase the amounts of physical activity performed by people with stroke or TIA are still unclear .
Therefore , the research question of this study was : what is the effect of lifestyle interventions on the level of physical activity performed by people with stroke or TIA ?