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.
Original languageEnglish
JournalBritish Journal of Sports Medicine
Publication statusAccepted - 15 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
  • TIA/transient ischaemic attack
  • stroke
  • secondary cardiovascular prevention
  • cardiac rehabilitation

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. 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 = "rehabiltation, TIA/transient ischaemic attack, stroke, secondary cardiovascular prevention, cardiac rehabilitation",
author = "Neil Heron and Margaret Cupples and Michael Donnelly and Frank Kee and Jonathan Mant",
year = "2019",
month = "9",
day = "15",
language = "English",
journal = "British Journal of Sports Medicine",
issn = "0306-3674",
publisher = "BMJ Publishing Group",

}

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 - Donnelly, Michael

AU - Kee, Frank

AU - Mant, Jonathan

PY - 2019/9/15

Y1 - 2019/9/15

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. 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.

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. 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.

KW - rehabiltation

KW - TIA/transient ischaemic attack

KW - stroke

KW - secondary cardiovascular prevention

KW - cardiac rehabilitation

M3 - Article

JO - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

SN - 0306-3674

ER -