School of Health Sciences, University of Newcastle, Newcastle, Australia.
Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia.
Disabil Rehabil. 2022 Feb;44(3):337-352. doi: 10.1080/09638288.2020.1768599. Epub 2020 Jun 1.
The risk of recurrent stroke following a transient ischaemic attack (TIA) or non-disabling stroke is high. Clinical guidelines recommend this patient population accumulate at least 150 minutes of moderate-to-vigorous physical activity each week to reduce the risk of recurrent stroke. We aimed to identify interventions that increase time adults spend in moderate-to-vigorous physical activity following TIA or non-disabling stroke.
We searched thirteen databases for articles of secondary prevention interventions reporting outcomes for duration in moderate-to-vigorous physical activity or exercise capacity.
Eight trials were identified ( = 2653). Of these, three ( = 198) reported changes in time spent in moderate-to-vigorous physical activity. Only one trial ( = 70), reported significant change in time spent engaging in moderate-to-vigorous physical activity (between-group difference: 11.7 min/day [95% CI 4.07-19.33]) when comparing participation in a six-month exercise education intervention to usual care. No trial measured moderate-to-vigorous physical activity after intervention end.
Despite recommendations to participate in regular physical activity at moderate-to-vigorous intensity for secondary stroke prevention, there is very little evidence for effective interventions for this patient population. There is need for clinically feasible interventions that result in long-term participation in physical activity in line with clinical guidelines. Protocol registration: PROSPERO CRD42018092840Implications for rehabilitationThere is limited evidence of the effectiveness of interventions that aim to increase time spent engaging in moderate-to-vigorous physical activity (MVPA) for people following a TIA or non-disabling stroke.A program comprising aerobic and resistance exercises ≥2 per week, supervised by a health professional (supplemented with a home program) over at least 24 weeks appears to be effective in assisting people adhere to recommended levels of moderate to vigorous physical activity after TIA or non-disabling stroke.Secondary prevention programs which include health professional supervised exercise sessions contribute to better adherence to physical activity guidelines; didactic sessions alone outlining frequency and intensity are unlikely to be sufficient.
短暂性脑缺血发作（TIA）或非致残性卒中后再次发生卒中的风险较高。临床指南建议该患者人群每周至少进行 150 分钟的中等到剧烈的身体活动，以降低再次发生卒中的风险。我们旨在确定可增加 TIA 或非致残性卒中后成年人进行中等到剧烈身体活动时间的干预措施。
我们在 13 个数据库中搜索了报告中等到剧烈身体活动或运动能力持续时间的二级预防干预措施的文章。
确定了 8 项试验（n=2653）。其中，3 项（n=198）报告了中等到剧烈身体活动时间的变化。只有一项试验（n=70）报告了中等到剧烈身体活动时间的显著变化（组间差异：11.7 分钟/天[95%CI 4.07-19.33]），当比较参加为期 6 个月的运动教育干预与常规护理时。没有试验在干预结束后测量中等到剧烈的身体活动。
尽管建议在 TIA 或非致残性卒中后进行规律的中等至剧烈强度的身体活动，但针对该患者人群的有效干预措施证据很少。需要有临床可行的干预措施，使患者长期参与符合临床指南的身体活动。方案注册：PROSPERO CRD42018092840。
TIA 或非致残性卒中后，旨在增加中等到剧烈体力活动（MVPA）时间的干预措施的有效性证据有限。每周进行 2 次或以上的有氧运动和阻力运动，由健康专业人员监督（辅以家庭方案）至少 24 周，似乎可有效帮助人们在 TIA 或非致残性卒中后遵守推荐的中等到剧烈体力活动水平。包括健康专业人员监督的运动课程的二级预防方案有助于更好地遵守身体活动指南；仅通过课堂教学来概述频率和强度不太可能足够。
