ExStroke Pilot Trial of the effect of repeated instructions to improve physical activity after ischaemic stroke: a multinational randomised controlled clinical trial.
OBJECTIVE
To investigate if repeated verbal instructions about physical activity to patients with ischaemic stroke could increase long term physical activity.


METHODS
Multicentre, multinational, randomised clinical trial with masked outcome assessment.


METHODS
Stroke units in Denmark, China, Poland, and Estonia.


METHODS
314 patients with ischaemic stroke aged >or=40 years who were able to walk-157 (mean age 69.7 years) randomised to the intervention, 157 (mean age 69.4 years) in the control group.


METHODS
Patients randomised to the intervention were instructed in a detailed training programme before discharge and at five follow-up visits during 24 months. Control patients had follow-up visits with the same frequency but without instructions in physical activity.


METHODS
Physical activity assessed with the Physical Activity Scale for the Elderly (PASE) at each visit. Secondary outcomes were clinical events.


RESULTS
The estimated mean PASE scores were 69.1 in the intervention group and 64.0 in the control group (difference 5.0 (95% confidence interval -5.8 to 15.9), P=0.36. The intervention had no significant effect on mortality, recurrent stroke, myocardial infarction, or falls and fractures.


CONCLUSIONS
Repeated encouragement and verbal instruction in being physically active did not lead to a significant increase in physical activity measured by the PASE score. More intensive strategies seem to be needed to promote physical activity after ischaemic stroke.


BACKGROUND
Clinical Trials NCT00132483.
Boysen
Gudrun
G
Department of Neurology, Bispebjerg Hospital, Copenhagen University Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark. gb01@bbh.regionh.dk
Krarup
Lars-Henrik
LH
Zeng
Xianrong
X
Oskedra
Adam
A
Kõrv
Janika
J
Andersen
Grethe
G
Gluud
Christian
C
Pedersen
Anders
A
Lindahl
Marianne
M
Hansen
Lotte
L
Winkel
Per
P
Truelsen
Thomas
T
D000328:Adult; D017677:Age Distribution; D000368:Aged; D003376:Counseling; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D055502:Secondary Prevention; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome