Home-based rehabilitation after TIA or minor stroke: pilot feasibility randomised trial of ‘The Healthy Brain Rehabilitation Manual’

Research output: Contribution to journalArticle

Abstract

Background
Whilst the importance of secondary prevention after transient ischaemic attack (TIA) or minor stroke is recognised research is sparse regarding novel effective ways in which to intervene in a primary care context.

Aim
To pilot a randomised controlled trial of a novel home-based prevention programme (‘The Healthy Brain Rehabilitation Manual’) for patients with TIA or ‘minor’ stroke.

Design and setting
Pilot randomised controlled trial, home-based.

Method
Patients within 4 weeks of a first TIA or ‘minor’ stroke received study information from clinicians in 4 hospitals. Participants were randomly allocated to: (1) standard care (control group) (n=12); (2) standard care, manual and GP follow-up (n=14); (3) standard care, manual and stroke nurse follow-up (n=14). All groups received telephone follow-up at 1, 4 and 9 weeks. We assessed eligibility, recruitment and retention; measured stroke/cardiovascular risk factors at baseline and 12 weeks; and elicited participants’ views about the study via focus groups.

Results
Over a 32-week period, 28% of clinic attendees (125/443) were eligible; 35% (44/125) consented to research contact; 91% (40/44) participated: 98% (39/40) completed the study. After 12 weeks, stroke risk factors improved in both intervention groups. The research methods and programme were acceptable to patients and health professionals who commented that the programme ‘filled a gap’ in current post-TIA management.

Conclusions
Our findings indicate that implementation of this novel home-based CR programme, and of a trial to evaluate its effectiveness, is feasible, with potential for clinically important benefits and improved secondary prevention following TIA or ‘minor’ stroke.

Keywords: cardiac rehabilitation; stroke; transient ischaemic attack; home-based program; randomized controlled trial; pilot study; secondary prevention
Original languageEnglish
JournalBritish Journal of General Practice
DOIs
Publication statusPublished - 10 Sep 2019

Fingerprint

Transient Ischemic Attack
Rehabilitation
Stroke
Brain
Secondary Prevention
Randomized Controlled Trials
Research
Focus Groups
Telephone
Primary Health Care
Myocardial Infarction
Nurses
Control Groups
Health

Keywords

  • rehabiltation
  • stroke
  • TIA/transient ischaemic attack
  • secondary cardiovascular prevention

Cite this

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title = "Home-based rehabilitation after TIA or minor stroke: pilot feasibility randomised trial of ‘The Healthy Brain Rehabilitation Manual’",
abstract = "Background Whilst the importance of secondary prevention after transient ischaemic attack (TIA) or minor stroke is recognised research is sparse regarding novel effective ways in which to intervene in a primary care context. AimTo pilot a randomised controlled trial of a novel home-based prevention programme (‘The Healthy Brain Rehabilitation Manual’) for patients with TIA or ‘minor’ stroke.Design and settingPilot randomised controlled trial, home-based. MethodPatients within 4 weeks of a first TIA or ‘minor’ stroke received study information from clinicians in 4 hospitals. Participants were randomly allocated to: (1) standard care (control group) (n=12); (2) standard care, manual and GP follow-up (n=14); (3) standard care, manual and stroke nurse follow-up (n=14). All groups received telephone follow-up at 1, 4 and 9 weeks. We assessed eligibility, recruitment and retention; measured stroke/cardiovascular risk factors at baseline and 12 weeks; and elicited participants’ views about the study via focus groups.ResultsOver a 32-week period, 28{\%} of clinic attendees (125/443) were eligible; 35{\%} (44/125) consented to research contact; 91{\%} (40/44) participated: 98{\%} (39/40) completed the study. After 12 weeks, stroke risk factors improved in both intervention groups. The research methods and programme were acceptable to patients and health professionals who commented that the programme ‘filled a gap’ in current post-TIA management.ConclusionsOur findings indicate that implementation of this novel home-based CR programme, and of a trial to evaluate its effectiveness, is feasible, with potential for clinically important benefits and improved secondary prevention following TIA or ‘minor’ stroke. Keywords: cardiac rehabilitation; stroke; transient ischaemic attack; home-based program; randomized controlled trial; pilot study; secondary prevention",
keywords = "rehabiltation, stroke, TIA/transient ischaemic attack, secondary cardiovascular prevention",
author = "Neil Heron and Margaret Cupples and Frank Kee and Michael Donnelly and Jonathan Mant",
year = "2019",
month = "9",
day = "10",
doi = "10.3399/bjgp19X705509",
language = "English",
journal = "British Journal of General Practice",
issn = "0960-1643",
publisher = "Royal College of General Practitioners",

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TY - JOUR

T1 - Home-based rehabilitation after TIA or minor stroke: pilot feasibility randomised trial of ‘The Healthy Brain Rehabilitation Manual’

AU - Heron, Neil

AU - Cupples, Margaret

AU - Kee, Frank

AU - Donnelly, Michael

AU - Mant, Jonathan

PY - 2019/9/10

Y1 - 2019/9/10

N2 - Background Whilst the importance of secondary prevention after transient ischaemic attack (TIA) or minor stroke is recognised research is sparse regarding novel effective ways in which to intervene in a primary care context. AimTo pilot a randomised controlled trial of a novel home-based prevention programme (‘The Healthy Brain Rehabilitation Manual’) for patients with TIA or ‘minor’ stroke.Design and settingPilot randomised controlled trial, home-based. MethodPatients within 4 weeks of a first TIA or ‘minor’ stroke received study information from clinicians in 4 hospitals. Participants were randomly allocated to: (1) standard care (control group) (n=12); (2) standard care, manual and GP follow-up (n=14); (3) standard care, manual and stroke nurse follow-up (n=14). All groups received telephone follow-up at 1, 4 and 9 weeks. We assessed eligibility, recruitment and retention; measured stroke/cardiovascular risk factors at baseline and 12 weeks; and elicited participants’ views about the study via focus groups.ResultsOver a 32-week period, 28% of clinic attendees (125/443) were eligible; 35% (44/125) consented to research contact; 91% (40/44) participated: 98% (39/40) completed the study. After 12 weeks, stroke risk factors improved in both intervention groups. The research methods and programme were acceptable to patients and health professionals who commented that the programme ‘filled a gap’ in current post-TIA management.ConclusionsOur findings indicate that implementation of this novel home-based CR programme, and of a trial to evaluate its effectiveness, is feasible, with potential for clinically important benefits and improved secondary prevention following TIA or ‘minor’ stroke. Keywords: cardiac rehabilitation; stroke; transient ischaemic attack; home-based program; randomized controlled trial; pilot study; secondary prevention

AB - Background Whilst the importance of secondary prevention after transient ischaemic attack (TIA) or minor stroke is recognised research is sparse regarding novel effective ways in which to intervene in a primary care context. AimTo pilot a randomised controlled trial of a novel home-based prevention programme (‘The Healthy Brain Rehabilitation Manual’) for patients with TIA or ‘minor’ stroke.Design and settingPilot randomised controlled trial, home-based. MethodPatients within 4 weeks of a first TIA or ‘minor’ stroke received study information from clinicians in 4 hospitals. Participants were randomly allocated to: (1) standard care (control group) (n=12); (2) standard care, manual and GP follow-up (n=14); (3) standard care, manual and stroke nurse follow-up (n=14). All groups received telephone follow-up at 1, 4 and 9 weeks. We assessed eligibility, recruitment and retention; measured stroke/cardiovascular risk factors at baseline and 12 weeks; and elicited participants’ views about the study via focus groups.ResultsOver a 32-week period, 28% of clinic attendees (125/443) were eligible; 35% (44/125) consented to research contact; 91% (40/44) participated: 98% (39/40) completed the study. After 12 weeks, stroke risk factors improved in both intervention groups. The research methods and programme were acceptable to patients and health professionals who commented that the programme ‘filled a gap’ in current post-TIA management.ConclusionsOur findings indicate that implementation of this novel home-based CR programme, and of a trial to evaluate its effectiveness, is feasible, with potential for clinically important benefits and improved secondary prevention following TIA or ‘minor’ stroke. Keywords: cardiac rehabilitation; stroke; transient ischaemic attack; home-based program; randomized controlled trial; pilot study; secondary prevention

KW - rehabiltation

KW - stroke

KW - TIA/transient ischaemic attack

KW - secondary cardiovascular prevention

U2 - 10.3399/bjgp19X705509

DO - 10.3399/bjgp19X705509

M3 - Article

JO - British Journal of General Practice

JF - British Journal of General Practice

SN - 0960-1643

ER -