期刊论文详细信息
Trials
Randomized controlled pilot study of a SystemCHANGE™ weight management intervention in stroke survivors: rationale and protocol
Jay Alberts3  Sue Jaeger1  Irene Katzan2  Fredrick Frost4  John P Kirwan7  Shirley M Moore5  Matthew Plow6 
[1] Cerebrovascular Center, Cleveland Clinic Neurological Institute, Cleveland, OH, 44195, USA;Neurological Institute Center for Outcomes Research and Evaluation, Cleveland Clinic, Cleveland, OH, 44195, USA;Department of Biomedical Engineering, Center for Neurological Restoration; Cleveland Clinic Lerner Research Institute, 9500 Euclid Ave, ND-20, Cleveland, OH, 44195, USA;Department Chair, Physical Medicine and Rehabilitation, Cleveland Clinic Neurological Institute, Cleveland, OH, 44195, USA;The Edward and Louise Mellen Professor of Nursing and Associate Dean for Research; Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106, USA;Department of Biomedical Engineering, Physical Medicine and Rehabilitation; Cleveland Clinic Lerner Research Institute, 9500 Euclid Ave, ND-20, Cleveland, OH, 44195, USA;Department of Pathobiology, Cleveland Clinic Lerner Research Institute, Cleveland, OH, 44195, USA
关键词: Sleep hygiene;    Diet;    Nutrition;    Physical activity;    Exercise;    Self-management;    Obesity;    Weight management;    Stroke;   
Others  :  1094088
DOI  :  10.1186/1745-6215-14-130
 received in 2013-02-01, accepted in 2013-04-25,  发布年份 2013
PDF
【 摘 要 】

Background

Over 65% of stroke survivors are either overweight or obese and have multiple cardiovascular risk factors. However, few studies have examined the effects of comprehensive lifestyle behavior interventions to promote weight loss and control cardiovascular risk factors in stroke survivors. Thus, the purpose of this study is to examine a novel behavior change approach - SystemCHANGE™ - to promote weight loss and improve health and function in stroke survivors. SystemCHANGE™ focuses on redesigning the social environment to achieve a specific goal.

Methods

We will conduct a randomized controlled pilot study to examine the efficacy, feasibility, and safety of the SystemCHANGE™ weight management program in overweight and obese stroke survivors. The central hypothesis of the study is that the SystemCHANGE™ intervention will help overweight and obese stroke survivors lose 5% of their body weight, thereby improving health and function. Thirty-five stroke survivors will be randomized into either the 6-month SystemCHANGE™ intervention or a contact-control intervention. Outcome measures will be assessed at baseline and again at 3 and 6 months after the interventions. Body composition will be assessed using a Bod Pod. Patient-reported outcomes will be the Stroke Impact Scale and Reintegration to Normal Living Index. Objective outcomes will include the 6-Minute Walking Test and Rivermead Motor Assessment.

Discussion

This study will be the first randomized controlled trial to evaluate the efficacy and safety of a weight management intervention in stroke survivors using the SystemCHANGE™ approach. Furthermore, it will be the first empirically-examined comprehensive lifestyle intervention designed to target physical activity, nutrition, and sleep to promote weight loss in stroke survivors.

Trial registration

ClinicalTrials.gov Identifier: NCT01776034

【 授权许可】

   
2013 Plow et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150130171638449.pdf 252KB PDF download
【 参考文献 】
  • [1]Kesarwani M, Perez A, Lopez VA, Wong ND, Franklin SS: Cardiovascular comorbidities and blood pressure control in stroke survivors. J Hypertens 2009, 27:1056-1063.
  • [2]Ivey FM, Macko RF, Ryan AS, Hafer-Macko CE: Cardiovascular health and fitness after stroke. Top Stroke Rehabil 2005, 12:1-16.
  • [3]Beamer NB, Coull BM, Clark WM, Briley DP, Wynn M, Sexton G: Persistent inflammatory response in stroke survivors. Neurology 1998, 50:1722-1728.
  • [4]Ivey FM, Ryan AS, Hafer-Macko CE, Garrity BM, Sorkin JD, Goldberg AP, Macko RF: High prevalence of abnormal glucose metabolism and poor sensitivity of fasting plasma glucose in the chronic phase of stroke. Cerebrovasc Dis 2006, 22:368-371.
  • [5]Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC, Halperin JL, Johnston SC, Katzan I, Kernan WN, Mitchell PH, Ovbiagele B, Palesch YY, Sacco RL, Schwamm LH, Wassertheil-Smoller S, Turan TN, Wentworth D, on behalf of the American Heart Association Stroke Council, Council on Cardiovascular Nursing, Council on Clinical Cardiology, and Interdisciplinary Council on Quality of Care and Outcomes Research: Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American heart Association/American stroke association. Stroke 2011, 42:227-276.
  • [6]Kopunek SP, Michael KM, Shaughnessy M, Resnick B, Nahm ES, Whitall J, Goldberg A, Macko RF: Cardiovascular risk in survivors of stroke. Am J Prev Med 2007, 32:408-412.
  • [7]Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, Carnethon MR, Dai S, de Simone G, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Greenlund KJ, Hailpern SM, Heit JA, Ho PM, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marellia A, Matchar DB, McDermott MM, Meigs JB, Moy CS: Heart disease and stroke statistics–2011 update: a report from the American heart association. Circulation 2011, 123:e18-e209.
  • [8]Rimmer JH, Wang E, Smith D: Barriers associated with exercise and community access for individuals with stroke. J Rehabil Res Dev 2008, 45:315-322.
  • [9]Rimmer JH: Exercise and physical activity in persons aging with a physical disability. Phys Med Rehabil Clin N Am 2005, 16:41-56.
  • [10]Redfern J, McKevitt C, Wolfe CD: Development of complex interventions in stroke care: a systematic review. Stroke 2006, 37:2410-2419.
  • [11]Seagle HM, Strain GW, Makris A, Reeves RS: Position of the American Dietetic Association: weight management. J Am Diet Assoc 2009, 109:330-346.
  • [12]Taheri S: The link between short sleep duration and obesity: we should recommend more sleep to prevent obesity. Arch Dis Child 2006, 91:881-884.
  • [13]Stuifbergen AK: Building health promotion interventions for persons with chronic disabling conditions. Fam Community Health 2006, 29:28S-34S.
  • [14]Webel AR, Moore SM, Hanson JE, Patel SR, Schmotzer B, Salata RA: Improving sleep hygiene behavior in adults living with HIV/AIDS: a randomized control pilot study of the SystemCHANGE™–HIV intervention. Appl Nurs Res 2012, pii:S0897-1897. (12)00074-2
  • [15]Sallis JF, Cervero RB, Ascher W, Henderson KA, Kraft MK, Kerr J: An ecological approach to creating active living communities. Annu Rev Public Health 2006, 27:297-322.
  • [16]Gregson J, Foerster SB, Orr R, Jones L, Benedict J, Clarke B, Hersey J, Lewis J, Zotz AK: System, environmental, and policy changes: using the social-ecological model as a framework for evaluating nutrition education and social marketing programs with low-income audiences. J Nutr Educ 2001, Suppl 1:S4-S15.
  • [17]Baranowski T, Cullen KW, Nicklas T, Thompson D, Baranowski J: Are current health behavioral change models helpful in guiding prevention of weight gain efforts? Obes Res 2003, Suppl 1:23S-43S.
  • [18]Butland RJ, Pang J, Gross ER, Woodcock AA, Geddes DM: Two-, six-, and 12-minute walking tests in respiratory disease. Br Med J (Clin Res Ed) 1982, 284:1607-1608.
  • [19]Katzman R, Brown T, Fuld P, Peck A, Schechter R, Schimmel H: Validation of a short orientation-memory-concentration test of cognitive impairment. A J Psychiatry 1983, 140:734-739.
  • [20]United States. Dept. of Health and Human Services, United States. Dept. of Agriculture, United States. Dietary Guidelines Advisory Committee: Dietary guidelines for Americans, 2010. 7th edition. Washington, D.C: G.P.O; 2010.
  • [21]Lorig KR, Holman H: Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med 2003, 26:1-7.
  • [22]Minderico CS, Silva AM, Teixeira PJ, Sardinha LB, Hull HR, Fields DA: Validity of air-displacement plethysmography in the assessment of body composition changes in a 16-month weight loss program. Nutr Metab (Lond) 2006, 3:32. BioMed Central Full Text
  • [23]Duncan PW, Bode RK, Min Lai S, Perera S: Rasch analysis of a new stroke-specific outcome scale: the stroke impact scale. Arch Phys Med Rehabil 2003, 84:950-963.
  • [24]Wood-Dauphinee S, Williams JI: Reintegration to normal living as a proxy to quality of life. J Chronic Dis 1987, 40:491-502.
  • [25]Lincoln N, Leadbitter D: Assessment of motor function in stroke patients. Physiotherapy 1979, 65:48-51.
  • [26]Rimmer JH, Riley BB, Rubin SS: A new measure for assessing the physical activity behaviors of persons with disabilities and chronic health conditions: the physical activity and disability survey. Am J Health Promot 2001, 16:34-42.
  • [27]Gershon RC, Lai JS, Bode R, Choi S, Moy C, Bleck T, Miller D, Peterman A, Cella D: Neuro-QOL: quality of life item banks for adults with neurological disorders: item development and calibrations based upon clinical and general population testing. Qual Life Res 2012, 21:475-486.
  • [28]Sallis J, Pinski R, Grossman T, Nader PR: The development of self-efficacy scales for health related diet and exercise behaviors. Health Educ Res 1988, 3:283-292.
  • [29]Marcus BH, Selby VC, Niaura RS, Rossi JS: Self-efficacy and the stages of exercise behavior change. Res Q Exerc Sport 1992, 63:60-66.
  • [30]Lorig KR, Sobel DS, Ritter PL, Laurent D, Hobbs M: Effect of a self-management program on patients with chronic disease. Eff Clin Pract 2001, 4:256-262.
  • [31]Sallis JF, Grossman RM, Pinski RB, Patterson TL, Nader PR: The development of scales to measure social support for diet and exercise behaviors. Prev Med 1987, 16:825-836.
  • [32]Hertzog MA: Considerations in determining sample size for pilot studies. Res Nurs Health 2008, 31:180-191.
  • [33]Dobkin BH: Progressive staging of pilot studies to improve phase III trials for motor interventions. Neurorehab Neural Repair 2009, 23:197-206.
  • [34]Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG: Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009, 42:377-381.
  • [35]Little RJ, D’Agostino R, Cohen ML, Dickersin K, Emerson SS, Farrar JT, Frangakis C, Hogan JW, Molenberghs G, Murphy SA, Neaton JD, Rotnitzky A, Scharfstein D, Shih WJ, Siegel JP, Stern H: The prevention and treatment of missing data in clinical trials. N Engl J Med 2012, 367:1355-1360.
  • [36]Rimmer J, Wang E, Yamaki K, Davis B: Documenting Disparities in Obesity and Disability. Focus: A Publication of the National Center for the Dissemination of Disability Research (NCDDR) 2010, 24:1-16.
  • [37]Liou TH, Pi-Sunyer FX, Laferrere B: Physical disability and obesity. Nutr Rev 2005, 63:321-331.
  • [38]Vemmos K, Ntaios G, Spengos K, Savvari P, Vemmou A, Pappa T, Manios E, Georgiopoulos G, Alevizaki M: Association between obesity and mortality after acute first-ever stroke: the obesity-stroke paradox. Stroke 2011, 42:30-36.
  • [39]Lavie CJ, Milani RV, Ventura HO: Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol 2009, 53:1925-1932.
  • [40]David RT: Loss of skeletal muscle mass in aging: examining the relationship of starvation, sarcopenia and cachexia. Clin Nutr 2007, 26:389-399.
  • [41]Rimmer JH, Wang E: Obesity prevalence among a group of Chicago residents with disabilities. Arch Phys Med Rehabil 2005, 86:1461-1464.
  • [42]Weil E, Wachterman M, McCarthy EP, Davis RB, O’Day B, Iezzoni LI, Wee CC: Obesity among adults with disabling conditions. JAMA 2002, 288:1265-1268.
  • [43]Plow M, Finlayson M: A qualitative study of nutritional behaviors in adults with multiple sclerosis. J Neurosci Nurs 2012, 44:337-350.
  文献评价指标  
  下载次数:6次 浏览次数:20次