Stepping up Aerobic Exercise to Improve Health Outcomes After Stroke (STROKE-TRIC)
21 mars 2018 mis à jour par: 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.
Aperçu de l'étude
Statut
Complété
Les conditions
Intervention / Traitement
Description détaillée
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.
Type d'étude
Observationnel
Inscription (Réel)
62
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
-
-
Nova Scotia
-
Halifax, Nova Scotia, Canada, B3H3J5
- QEII Health Sciences Centre
-
-
Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans et plus (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
Méthode d'échantillonnage
Échantillon non probabiliste
Population étudiée
Patients post-stroke
La description
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
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
Cohortes et interventions
Groupe / Cohorte |
Intervention / Traitement |
|---|---|
|
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.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Change from admission 6-Minute Walk Test at discharge
Délai: 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)
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Change from admission 10-Meter Walk at discharge
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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)
|
Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Réel)
30 janvier 2016
Achèvement primaire (Réel)
26 janvier 2018
Achèvement de l'étude (Réel)
26 janvier 2018
Dates d'inscription aux études
Première soumission
14 novembre 2014
Première soumission répondant aux critères de contrôle qualité
18 novembre 2014
Première publication (Estimation)
20 novembre 2014
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
23 mars 2018
Dernière mise à jour soumise répondant aux critères de contrôle qualité
21 mars 2018
Dernière vérification
1 mars 2018
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- CDHA-RS 2015-223
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
NON
Description du régime IPD
We plan to disseminate the findings through a peer-reviewed publication.
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
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