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Stepping up Aerobic Exercise to Improve Health Outcomes After Stroke (STROKE-TRIC)

2018년 3월 21일 업데이트: 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.

연구 개요

상세 설명

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.

연구 유형

관찰

등록 (실제)

62

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • Nova Scotia
      • Halifax, Nova Scotia, 캐나다, B3H3J5
        • QEII Health Sciences Centre

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 이상 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

샘플링 방법

비확률 샘플

연구 인구

Patients post-stroke

설명

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

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

코호트 및 개입

그룹/코호트
개입 / 치료
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.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Change from admission 6-Minute Walk Test at discharge
기간: 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)

2차 결과 측정

결과 측정
측정값 설명
기간
Change from admission 10-Meter Walk at discharge
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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)

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2016년 1월 30일

기본 완료 (실제)

2018년 1월 26일

연구 완료 (실제)

2018년 1월 26일

연구 등록 날짜

최초 제출

2014년 11월 14일

QC 기준을 충족하는 최초 제출

2014년 11월 18일

처음 게시됨 (추정)

2014년 11월 20일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2018년 3월 23일

QC 기준을 충족하는 마지막 업데이트 제출

2018년 3월 21일

마지막으로 확인됨

2018년 3월 1일

추가 정보

이 연구와 관련된 용어

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

아니요

IPD 계획 설명

We plan to disseminate the findings through a peer-reviewed publication.

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

아니

미국 FDA 규제 기기 제품 연구

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

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