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 ?
Efficacy of a Chronic Care–Based Intervention on Secondary Stroke Prevention Among Vulnerable Stroke Survivors: A Randomized Controlled Trial
Background : Disparities of care among stroke survivors are well documented . Effective interventions to improve recurrent stroke preventative care in vulnerable population s are lacking . Methods and Results : In a r and omized controlled trial , we tested the efficacy of components of a chronic care model – based intervention versus usual care among 404 subjects having an ischemic stroke or transient ischemic attack within 90 days of enrollment and receiving care within the Los Angeles public healthcare system . Subjects had baseline systolic blood pressure ( SBP ) ≥120 mm Hg .  The intervention included a nurse practitioner/physician assistant care manager , group clinics , self-management support , report cards , decision support , and ongoing care coordination . Outcomes were collected at 3 , 8 , and 12 months , analyzed as intention-to-treat , and used repeated- measures mixed-effects models . Change in SBP was the primary outcome . Low-density lipoprotein reduction , antithrombotic medication use , smoking cessation , and physical activity were secondary outcomes . Average age was 57 years ; 18 % were of black race ; 69 % were of Hispanic ethnicity . Mean baseline SBP was 150 mm Hg in both arms . SBP decreased to 17 mm Hg in the intervention arm and 14 mm Hg in the usual care arm ; the between-arm difference was not significant ( −3.6 mm Hg ; 95 % confidence interval , −9.2 to 2.2 ) . Among secondary outcomes , the only significant difference was that persons in the intervention arm were more likely to lower their low-density lipoprotein < 100 md/dL ( 2.0 odds ratio ; 95 % confidence interval , 1.1–3.5 ) . Conclusions : This intervention did not improve SBP control beyond that attained in usual care among vulnerable stroke survivors . A community-centered component could strengthen the intervention impact . Clinical Trial Registration : URL : https:// clinical trials.gov . Unique identifier : NCT00861081
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 ?