Clinical trial NCT02296268: Stepping up Aerobic Exercise to Improve Health Outcomes After Stroke
Official title: Stepping up Aerobic Exercise to Improve Health Outcomes After Stroke: Translating Research Into Clinical Care
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Stroke
Keywords: stroke
aerobic exercise
screening
prescription
Lead sponsor: Nova Scotia Health Authority
Sponsor class: OTHER
First posted: 2014-11-20
Enrollment: 62
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients post-stroke

Brief summary: Stroke is a leading cause of chronic disability here in Nova Scotia and globally. Aerobic exercise is known to improve health by increasing energy levels, physical mobility, balance, bone health, cardiovascular risk reduction, mental well-being, cognition, sleep, and quality of life. Nonetheless, people remain woefully inactive after stroke, regardless if they are in hospital or at home. The current investigative team and others have shown that even during physiotherapy, exercise intensity is not adequate to increase physical fitness. Consequently, patients are often deprived of a treatment that could improve their recovery. Why does this gap between evidence and clinical practice persist? Through a national survey the current team found that an important contributing factor is lack of appropriate screening (especially stress tests) to ensure that patients are safe to engage in aerobic exercise. This project is designed to close this evidence-practice gap by establishing a state-of-the-art aerobic exercise screening and prescription clinic at the Nova Scotia Rehabilitation Centre (NSRC). The intent is to compare outcomes of stroke rehabilitation participants before and after the clinic is underway and determine if the clinic has a positive effect on the confidence of NSRC physiotherapists to use aerobic exercise safely and effectively in stroke rehabilitation.

Detailed description: Research question: To what extent does an on-site aerobic exercise screening and prescription clinic effect uptake of aerobic exercise and patient outcomes in in-patient stroke rehabilitation?

Design: Pre-post cohort design to explore real-world application and feasibility

Aim 1. Establish an aerobic exercise screening and prescription clinic (herein 'Aerobics Clinic') at the NSRC.

Aim 2. Assess the potential impact of the Aerobics Clinic on the self-efficacy of physiotherapists at NSRC regarding clinical utilization of aerobic exercise in in-patient stroke rehabilitation.

Method: An assessment of the physiotherapy participants' self-efficacy regarding the clinical utilization of aerobic exercise post-stroke will be conducted prior to, and after, implementation of the Clinic.

Aim 3: Assess the potential impact of the Aerobics Clinic on prescription and treatment practices regarding aerobic exercise among patients in stroke rehabilitation at the NSRC.

Method: Prior to, and after, implementation of the Clinic the actual utilization of aerobic exercise in the practices of the physiotherapy participants will be assessed using heart rate monitoring, activity monitoring, and health record review.

Eligibility criteria: Inclusion Criteria:

* Male or female adults
* Diagnosed with ischemic or hemorrhagic stroke
* Referred to NSRC for stroke rehabilitation

Exclusion Criteria:

* Have contraindications to exercise testing using American College of Sports Medicine guidelines

Primary outcomes:
measure: Change from admission 6-Minute Walk Test at discharge
timeFrame: admission and discharge (baseline and 5-6 weeks later)
Secondary outcomes:
measure: Change from admission 10-Meter Walk at discharge
timeFrame: admission and discharge (baseline and ~5-6 weeks later)
measure: Change from admission resting blood pressure at discharge
timeFrame: admission and discharge (baseline and 5-6 weeks later)
measure: Change from admission abdominal girth at discharge
timeFrame: admission and discharge
measure: Change from admission Stroke-Specific Quality of Life at discharge
timeFrame: admission and discharge (baseline and 5-6 weeks later)
measure: Change from admission Readiness for Physical Activity Scale at discharge
timeFrame: admission and discharge (baseline and 5-6 weeks later)
measure: Change from admission Fatigue Severity Scale at discharge
timeFrame: admission and discharge (baseline and 5-6 weeks later)
Other outcomes:
Locations:
city: Halifax
country: Canada
facility: QEII Health Sciences Centre
state: Nova Scotia
Study officials:
References: