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中风的二级预防。一项远程医疗提供的体育活动和饮食的先导随机试验(ENAbLE-pilot)。

Secondary prevention of stroke. A telehealth-delivered physical activity and diet pilot randomized trial (ENAbLE-pilot).

机构信息

School of Health Sciences, University of Newcastle, Newcastle, NSW, Australia.

Heart and Stroke Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.

出版信息

Int J Stroke. 2024 Feb;19(2):199-208. doi: 10.1177/17474930231201360. Epub 2023 Sep 29.

Abstract

BACKGROUND

Improving physical activity levels and diet quality are important for secondary stroke prevention.

AIM

To test the feasibility and safety of 6-month, co-designed telehealth-delivered interventions to increase physical activity and improve diet quality.

METHODS

A 2 × 2 factorial trial (physical activity (PA); diet (DIET); PA + DIET; control) randomized, open-label, blinded endpoint trial. Primary outcomes were feasibility and safety. Secondary outcomes included stroke risk factors (blood pressure, self-report PA (International Physical Activity Questionnaire (IPAQ)) and diet quality (Australian Recommended Food Score (ARFS)), and quality of life. Between-group differences were analyzed using linear-mixed models.

RESULTS

Over 23 months, 99 people were screened for participation and 40 (40%) randomized (3 months to 10 years post-stroke, mean age 59 (16) years). Six participants withdrew, and an additional five were lost to follow-up. Fifteen serious adverse events were reported, but none were deemed definitely or probably related to the intervention. Median attendance was 32 (of 36) PA sessions and 9 (of 10) DIET sessions. The proportion of missing primary outcome data (blood pressure) was 3% at 3 months, 11% at 6 months, and 14% at 12 months. Between-group 95% confidence intervals showed promising, clinically relevant differences in support of the interventions across the range of PA, diet quality, and blood pressure outcomes.

CONCLUSION

Our telehealth PA and diet interventions were safe and feasible and may have led to significant behavior change.

TRIAL REGISTRATION

ACTRN12620000189921.

摘要

背景

提高身体活动水平和饮食质量对于二级卒中预防很重要。

目的

测试 6 个月、共同设计的远程医疗干预措施来增加身体活动和改善饮食质量的可行性和安全性。

方法

这是一项 2×2 析因试验(身体活动(PA);饮食(DIET);PA+DIET;对照组),随机、开放标签、盲终点试验。主要结局是可行性和安全性。次要结局包括卒中危险因素(血压、自我报告的身体活动(国际体力活动问卷(IPAQ))和饮食质量(澳大利亚推荐食物评分(ARFS)),以及生活质量。使用线性混合模型分析组间差异。

结果

在 23 个月的时间里,有 99 人接受了参与筛选,有 40 人(3 至 10 年卒中后,平均年龄 59(16)岁)被随机分组。6 名参与者退出,另外 5 名失访。报告了 15 例严重不良事件,但没有一例被认为与干预措施肯定或可能相关。中位数出席率为 32 次(36 次)PA 课程和 9 次(10 次)DIET 课程。主要结局数据(血压)缺失比例为 3 个月时 3%,6 个月时 11%,12 个月时 14%。组间 95%置信区间显示出有希望的、临床相关的差异,支持 PA、饮食质量和血压结果的干预措施。

结论

我们的远程医疗 PA 和饮食干预措施是安全可行的,可能导致了显著的行为改变。

试验注册

ACTRN12620000189921。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd67/10811968/0caf9bbbd20a/10.1177_17474930231201360-fig1.jpg

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