Stepping up Aerobic Exercise to Improve Health Outcomes After Stroke (STROKE-TRIC)
21. marts 2018 opdateret af: Marilyn MacKay-Lyons, Nova Scotia Health Authority
Stepping up Aerobic Exercise to Improve Health Outcomes After Stroke: Translating Research Into Clinical Care
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.
Studieoversigt
Status
Afsluttet
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
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.
Undersøgelsestype
Observationel
Tilmelding (Faktiske)
62
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
-
-
Nova Scotia
-
Halifax, Nova Scotia, Canada, B3H3J5
- QEII Health Sciences Centre
-
-
Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
18 år og ældre (Voksen, Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Prøveudtagningsmetode
Ikke-sandsynlighedsprøve
Studiebefolkning
Patients post-stroke
Beskrivelse
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
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Kohorter og interventioner
Gruppe / kohorte |
Intervention / Behandling |
|---|---|
|
Pre-Clinic Stroke Group
In- or out-patients with diagnosis of ischemic or hemorrhagic stroke who have been referred to the NSRC prior to the establishment of the Clinic and are willing/able to provide written informed consent and have no contraindications to exercise testing.
Utilization of aerobic exercise will be monitored during their physiotherapy sessions (Aim 3).
|
Patients will be referred to the Clinic by their physiotherapist to be assessed regarding their safety and readiness to participate in aerobic training.
If they are deemed to be safe and ready, an aerobic exercise prescription will be written to guide the implementation of a safe and effective training protocol.
Patients deemed to be at moderate to high risk will need to be cleared for testing by a physician on the stroke service.
A cardiologist will be consulted about specific concerns re cardiac status.
|
|
Post-Clinic Stroke Group
In- or out-patients with diagnosis of ischemic or hemorrhagic stroke who have been referred to the NSRC after the establishment of the Clinic and are willing/able to provide written informed consent and have no contraindications to exercise testing.
Each patient will undergo an assessment in the Aerobics Clinic and will receive a prescription for aerobic training based on the assessment findings.
Utilization of aerobic exercise will be monitored during their physiotherapy sessions (Aim 3).
|
Patients will be referred to the Clinic by their physiotherapist to be assessed regarding their safety and readiness to participate in aerobic training.
If they are deemed to be safe and ready, an aerobic exercise prescription will be written to guide the implementation of a safe and effective training protocol.
Patients deemed to be at moderate to high risk will need to be cleared for testing by a physician on the stroke service.
A cardiologist will be consulted about specific concerns re cardiac status.
|
|
Stroke Rehabilitation Physiotherapists
Physiotherapists whose current practice involves working full-time or part-time on in- or out-patient stroke service at the NSRC.
Their self-efficacy regarding the clinical utilization of aerobic exercise post-stroke will be conducted prior to, and after, implementation of the Aerobics Clinic.
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change from admission 6-Minute Walk Test at discharge
Tidsramme: admission and discharge (baseline and 5-6 weeks later)
|
To assess change between admission and discharge in distance walked without manual support in 6 minutes
|
admission and discharge (baseline and 5-6 weeks later)
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change from admission 10-Meter Walk at discharge
Tidsramme: admission and discharge (baseline and ~5-6 weeks later)
|
To assess change between admission and discharge in n walking speed over a 10-metre distance
|
admission and discharge (baseline and ~5-6 weeks later)
|
|
Change from admission resting blood pressure at discharge
Tidsramme: admission and discharge (baseline and 5-6 weeks later)
|
To assess change between admission and discharge in resting systolic and diastolic blood pressure
|
admission and discharge (baseline and 5-6 weeks later)
|
|
Change from admission abdominal girth at discharge
Tidsramme: admission and discharge
|
To assess change between admission and discharge in waist circumference in relaxed standing position
|
admission and discharge
|
|
Change from admission Stroke-Specific Quality of Life at discharge
Tidsramme: admission and discharge (baseline and 5-6 weeks later)
|
To assess change between admission and discharge in quality of life questionnaire
|
admission and discharge (baseline and 5-6 weeks later)
|
|
Change from admission Readiness for Physical Activity Scale at discharge
Tidsramme: admission and discharge (baseline and 5-6 weeks later)
|
To assess change between admission and discharge in readiness to engage in physical activity
|
admission and discharge (baseline and 5-6 weeks later)
|
|
Change from admission Fatigue Severity Scale at discharge
Tidsramme: admission and discharge (baseline and 5-6 weeks later)
|
To assess change between admission and discharge in level of fatigue
|
admission and discharge (baseline and 5-6 weeks later)
|
Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart (Faktiske)
30. januar 2016
Primær færdiggørelse (Faktiske)
26. januar 2018
Studieafslutning (Faktiske)
26. januar 2018
Datoer for studieregistrering
Først indsendt
14. november 2014
Først indsendt, der opfyldte QC-kriterier
18. november 2014
Først opslået (Skøn)
20. november 2014
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
23. marts 2018
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
21. marts 2018
Sidst verificeret
1. marts 2018
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- CDHA-RS 2015-223
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
INGEN
IPD-planbeskrivelse
We plan to disseminate the findings through a peer-reviewed publication.
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