Key result
A home-based cardiac rehabilitation program implemented within 4 weeks of a first TIA or minor stroke was feasible, achieving a 54% recruitment rate and 100% retention over 6 weeks.
Why the study?
Is an adapted home-based cardiac rehabilitation programme feasible for patients following a first TIA or minor stroke?
RCT (n=15)
Open-label
Computer generated
No
Is an adapted home-based cardiac rehabilitation programme feasible for patients following a first TIA or minor stroke?
An adapted home-based cardiac rehabilitation program is feasible for patients recovering from a recent TIA or minor stroke, supporting progression to a pilot efficacy study.
Supports randomized trials of early home-based cardiac rehabilitation after TIA; does not yet warrant practice change.
BACKGROUND: The value of cardiac rehabilitation (CR) after a transient ischaemic attack (TIA) or minor stroke is untested despite these conditions sharing similar pathology and risk factors to coronary heart disease. We aimed to evaluate the feasibility of conducting a trial of an adapted home-based CR programme, 'The Healthy Brain Rehabilitation Manual', for patients following a TIA/minor stroke, participants' views on the intervention and, to identify the behaviour change techniques (BCTs) used. METHODS: Clinicians were asked to identify patients attending the Ulster Hospital, Belfast within 4 weeks of a first TIA or minor stroke. Those who agreed to participate underwent assessments of physical fitness, cardiovascular risk, quality of life and mental health, before random allocation to: Group (1) standard/usual care; (2) rehabilitation manual or (3) manual plus pedometer. All participants received telephone support at 1 and 4 weeks, reassessment at 6 weeks and an invitation to a focus group exploring views regarding the study. Two trained review authors independently assessed the manual to identify the BCTs used. RESULTS: testing, which all declined. The manual and telephone contact were viewed positively, as credible sources of advice. Pedometers were valued highly, particularly for goal-setting. Overall, 36 individual BCTs were used, the commonest being centred around setting goals and planning as well as social support. CONCLUSION: Recruitment and retention rates suggest that a trial to evaluate the effectiveness of a novel home-based CR programme, implemented within 4 weeks of a first TIA/minor stroke is feasible. The commonest BCTs used within the manual revolve around goals, planning and social support, in keeping with UK national guidelines. The findings from this feasibility work have been used to further refine the next stage of the intervention's development, a pilot study. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02712385 . This study was registered prospectively on 18/03/2016.
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Heron et al. (2017) conducted an RCT in TIA or minor stroke (n=15). The Healthy Brain Rehabilitation Manual (with or without pedometer) vs. Standard/usual care was evaluated on Feasibility (retention rate). A home-based cardiac rehabilitation program implemented within 4 weeks of a first TIA or minor stroke was feasible, achieving a 54% recruitment rate and 100% retention over 6 weeks.
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