General lifestyle interventions on their own seem insufficient to improve the level of physical activity after stroke or TIA: a systematic review

BMC Neurology

Lara Vlietstra¹  Roderick Wondergem²  Wendy Hendrickx²  Karin Valkenet²  Martijn Frits Pisters²  Cindy Veenhof²  Coralie English³ 

[1] Department of Medicine, Dunedin School of Medicine and School of Physiotherapy, University of Otago;Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University;School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle;

关键词: Stroke;    Lifestyle;    Risk reduction behaviour;    Secondary prevention;    Exercise;   

DOI  :  10.1186/s12883-020-01730-3

来源: DOAJ

【 摘 要 】

Abstract Background Insufficient amounts of physical activity is a risk factor for (recurrent) stroke. People with a stroke or transient ischemic attack (TIA) have a high risk of recurrent stroke and have lower levels of physical activity than their healthy peers. Though several reviews have looked at the effects of lifestyle interventions on a number of risk factors of recurrent stroke, the effectiveness of these interventions to increase the amounts of physical activity performed by people with stroke or TIA are still unclear. Therefore, the research question of this study was: what is the effect of lifestyle interventions on the level of physical activity performed by people with stroke or TIA? Method A systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Pubmed, Embase and Cumulative Index for Nursing and Allied Health Literature (CINAHL), were searched up to August 2018. Randomised controlled trials that compared lifestyle interventions, aimed to increase the amount of physical activity completed by participants with a stroke or TIA, with controls were included. The Physiotherapy Evidence Database (PEDro) score was used to assess the quality of the articles, and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method for the best evidence synthesis. Results Eleven trials (n = 2403) met the inclusion criteria. The quality of the trials was mostly high, with 8 (73%) of trials scoring ≥6 on the PEDro scale. The overall best evidence syntheses showed moderate quality evidence that lifestyle interventions do not lead to significant improvements in the physical activity level of people with stroke or TIA. There is low quality evidence that lifestyle interventions that specifically target physical activity are effective at improving the levels of physical activity of people with stroke or TIA. Conclusion Based on the results of this review, general lifestyle interventions on their own seem insufficient in improving physical activity levels after stroke or TIA. Lifestyle interventions that specifically encourage increasing physical activity may be more effective. Further properly powered trials using objective physical activity measures are needed to determine the effectiveness of such interventions. Trial registration PROSPERO, CRD42018094437 .

【 授权许可】

Unknown