Stepping up Aerobic Exercise to Improve Health Outcomes After Stroke (STROKE-TRIC)
21. März 2018 aktualisiert von: 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.
Studienübersicht
Status
Abgeschlossen
Bedingungen
Intervention / Behandlung
Detaillierte Beschreibung
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.
Studientyp
Beobachtungs
Einschreibung (Tatsächlich)
62
Kontakte und Standorte
Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.
Studienorte
-
-
Nova Scotia
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Halifax, Nova Scotia, Kanada, B3H3J5
- QEII Health Sciences Centre
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Teilnahmekriterien
Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.
Zulassungskriterien
Studienberechtigtes Alter
18 Jahre und älter (Erwachsene, Älterer Erwachsener)
Akzeptiert gesunde Freiwillige
Nein
Studienberechtigte Geschlechter
Alle
Probenahmeverfahren
Nicht-Wahrscheinlichkeitsprobe
Studienpopulation
Patients post-stroke
Beschreibung
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
Studienplan
Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.
Wie ist die Studie aufgebaut?
Designdetails
Kohorten und Interventionen
Gruppe / Kohorte |
Intervention / Behandlung |
|---|---|
|
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.
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Change from admission 6-Minute Walk Test at discharge
Zeitfenster: 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)
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Change from admission 10-Meter Walk at discharge
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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)
|
Mitarbeiter und Ermittler
Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.
Sponsor
Studienaufzeichnungsdaten
Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.
Haupttermine studieren
Studienbeginn (Tatsächlich)
30. Januar 2016
Primärer Abschluss (Tatsächlich)
26. Januar 2018
Studienabschluss (Tatsächlich)
26. Januar 2018
Studienanmeldedaten
Zuerst eingereicht
14. November 2014
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
18. November 2014
Zuerst gepostet (Schätzen)
20. November 2014
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
23. März 2018
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
21. März 2018
Zuletzt verifiziert
1. März 2018
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
- CDHA-RS 2015-223
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
NEIN
Beschreibung des IPD-Plans
We plan to disseminate the findings through a peer-reviewed publication.
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Nein
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
Nein
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