1
|
Hall P, Lawrence M, Kroll T, Blake C, Matthews J, Lennon O. Reducing risk behaviours after stroke: An overview of reviews interrogating primary study data using the Theoretical Domains Framework. PLoS One 2024; 19:e0302364. [PMID: 38669261 PMCID: PMC11051587 DOI: 10.1371/journal.pone.0302364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Lifestyle changes, in addition to preventive medications, optimise stroke secondary prevention. Evidence from systematic reviews support behaviour-change interventions post-stroke to address lifestyle-related risk. However, understanding of the theory-driven mediators that affect behaviour-change post-stroke is lacking. METHODS Electronic databases MEDLINE, Embase, Epistemonikos and Cochrane Library of Systematic Reviews were searched to March 2023 for systematic reviews addressing behaviour-change after stroke. Primary studies from identified systematic reviews were interrogated for evidence supporting theoretically-grounded interventions. Data were synthesized in new meta-analyses examining behaviour-change domains of the Theoretical Domains Framework (TDF) and secondary prevention outcomes. RESULTS From 71 identified SRs, 246 primary studies were screened. Only 19 trials (N = 2530 participants) were identified that employed theoretically-grounded interventions and measured associated mediators for behaviour-change. Identified mediators mapped to 5 of 14 possible TDF domains. Trial follow-up ranged between 1-12 months and no studies addressed primary outcomes of recurrent stroke or cardiovascular mortality and/or morbidity. Lifestyle interventions targeting mediators mapped to the TDF Knowledge domain may improve the likelihood of medication adherence (OR 6.08 [2.79, 13.26], I2 = 0%); physical activity participation (OR 2.97 [1.73, 5.12], I2 = 0%) and smoking cessation (OR 10.37 [3.22, 33.39], I2 = 20%) post-stroke, supported by low certainty evidence; Lifestyle interventions targeting mediators mapping to both TDF domains of Knowledge and Beliefs about Consequences may improve medication adherence post-stroke (SMD 0.36 [0.07, 0.64], I2 = 13%, very low certainty evidence); Lifestyle interventions targeting mediators mapped to Beliefs about Capabilities and Emotions domains may modulate low mood post-stroke (SMD -0.70 [-1.28, -0.12], I2 = 81%, low certainty evidence). CONCLUSION Limited theory-based research and use of behaviour-change mediators exists within stroke secondary prevention trials. Knowledge, Beliefs about Consequences, and Emotions are the domains which positively influence risk-reducing behaviours post-stroke. Behaviour-change interventions should include these evidence-based constructs known to be effective. Future trials should address cardiovascular outcomes and ensure adequate follow-up time.
Collapse
Affiliation(s)
- Patricia Hall
- School of Public Health, Physiotherapy and Sports Science, Health Science Centre, University College Dublin, Dublin, Ireland
- iPASTAR (Improving Pathways for Acute Stroke and Rehabilitation) Collaborative Doctoral Award, Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Maggie Lawrence
- Department of Nursing and Community Health, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Thilo Kroll
- School of Nursing, Midwifery and Health Systems, Health Science Centre, University College Dublin, Dublin, Ireland
| | - Catherine Blake
- School of Public Health, Physiotherapy and Sports Science, Health Science Centre, University College Dublin, Dublin, Ireland
| | - James Matthews
- School of Public Health, Physiotherapy and Sports Science, Health Science Centre, University College Dublin, Dublin, Ireland
| | - Olive Lennon
- School of Public Health, Physiotherapy and Sports Science, Health Science Centre, University College Dublin, Dublin, Ireland
| |
Collapse
|
2
|
Kim J, Bae YH, Ho SH, Lee H, Park H. Feasibility and outcomes of a community-based, mobile health system-monitored lifestyle intervention in chronic stroke: A pilot study. Technol Health Care 2024:THC230857. [PMID: 38517811 DOI: 10.3233/thc-230857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
BACKGROUND People with disabilities face challenges in daily life during the COVID-19 pandemic, including limited access to care, exposure to lifestyle-related diseases, and difficulties in regular exercise. Therefore, it is important to establish health safety nets using Information and Communication Technology (ICT) in communities. OBJECTIVE This study aimed to develop an m-Health-based personalized lifestyle intervention algorithm targeting high-risk groups of lifestyle-related diseases (including hypertension, diabetes, and obesity) among people with hemiplegic disabilities, and to verify its feasibility. METHODS Six people at a high risk of lifestyle-related diseases participated in an 8-week lifestyle intervention using a wearable device and the S-Health program. The self-health management areas included walking, moderate-intensity exercise, weight, blood pressure, blood sugar, diet, calorie intake, heart rate, sobriety, no smoking. Health, physical, psychological, and social changes were measured before and after the study. RESULTS The intervention had a positive impact on the participants' health, with statistically significant differences found in fasting blood glucose, highest systolic blood pressure, grip strength, and motor function assessment. Quality of life, health-related quality of life, and self-efficacy improved post-intervention. CONCLUSION Our findings can be used as preliminary evidence for establishing m-Health-based health safety net systems for people with disabilities who live in communities.
Collapse
|
3
|
Chun CT(N, MacDonald-Wicks L, English C, Lannin NA, Patterson A. Scoping Review of Available Culinary Nutrition Interventions for People with Neurological Conditions. Nutrients 2024; 16:462. [PMID: 38337746 PMCID: PMC10857153 DOI: 10.3390/nu16030462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
People with neurological conditions may face barriers to meal preparation. Culinary nutrition interventions aim to facilitate the building of knowledge and skills for meal preparation. This scoping review aims to map the available evidence for culinary nutrition interventions for people with neurological conditions and evaluate the quality of these interventions based on program design, delivery and evaluation. After a systematic search of online databases (MEDLINE, CINAHL, Embase, Scopus and Proquest) and reference lists, a total of ten publications describing nine interventions were included. Most interventions were designed for people with stroke and/or Transient Ischemic Attack (n = 3) and Multiple Sclerosis (n = 3); others were for traumatic brain injury (n = 1), mild dementia (n = 1) and Parkinson's Disease (n = 1). Overall, the included culinary nutrition interventions had good program delivery (inclusion of motivational experiences, delivered by appropriate health providers) but needed improvements in program design (lack of consumer engagement and neurological symptom accommodations) and evaluation (lack of complete process, outcome and impact evaluations). In conclusion, the evidence base for culinary nutrition interventions for people with neurological conditions remains sparse. To bridge the gap between theory and practice, it is important to consider the following aspects in culinary nutrition intervention planning/improvement: (I) the involvement of consumers; (II) the accommodation/tailoring for post-condition effects; and (III) the coverage of all disease-specific culinary nutrition aspects.
Collapse
Affiliation(s)
- Chian Thong (Nicole) Chun
- School of Health Sciences, Faculty of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (C.T.C.); (L.M.-W.); (C.E.)
| | - Lesley MacDonald-Wicks
- School of Health Sciences, Faculty of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (C.T.C.); (L.M.-W.); (C.E.)
- Hunter Medical Research Institute Food and Nutrition Research Program, New Lambton Heights, NSW 2305, Australia
| | - Coralie English
- School of Health Sciences, Faculty of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (C.T.C.); (L.M.-W.); (C.E.)
- Hunter Medical Research Institute Heart and Stroke Research Program, New Lambton Heights, NSW 2305, Australia
| | - Natasha A. Lannin
- Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia;
- Allied Health, Alfred Health, Melbourne, VIC 3004, Australia
| | - Amanda Patterson
- School of Health Sciences, Faculty of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (C.T.C.); (L.M.-W.); (C.E.)
- Hunter Medical Research Institute Food and Nutrition Research Program, New Lambton Heights, NSW 2305, Australia
| |
Collapse
|
4
|
Goncalves S, Le Bourvellec M, Mandigout S, Duclos NC. Impact of Active Physiotherapy on Physical Activity Level in Stroke Survivors: A Systematic Review and Meta-Analysis. Stroke 2023; 54:3097-3106. [PMID: 37909205 DOI: 10.1161/strokeaha.123.043629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/05/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND Stroke survivors are frequently physically inactive. However, evidence of the effectiveness of active physiotherapy on physical activity level in stroke survivors is scarce. METHODS We conducted a systematic review and meta-analysis of randomized controlled trials according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement, covering electronic searches from inception to March 16, 2022. Participants: Stroke survivors living in the community. Intervention: Any active physiotherapy, that is, involving exercises that require voluntary effort. Outcome measure: Objective and subjective physical activity level. RESULTS Of 5590 identified references, 25 randomized controlled trials were eligible, and 21 had available data. The random-effects meta-analysis resulted in a small, significant effect size in favor of active physiotherapy measured using objective or subjective tools (21 studies, 1834 participants, standardized mean difference, 0.22 [95% CI, 0.04-0.40]; heterogeneity I2=65%), and a medium significant effect when objective tools were used (9 studies, 424 participants, standardized mean differences, 0.48 [95% CI, 0.03-0.92]; I2=73%). Meta-regression showed that 35% of the variance in trial outcome was explained by the measurement tool (objective or subjective) and 23% by age. None of the variances were associated with a specific dosage in terms of frequency, time, exercise duration, or the severity of the disability. CONCLUSIONS Active physiotherapy seems to increase objective physical activity in community-dwelling stroke survivors. However, the evidence is of very low certainty. REGISTRATION URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42022315639.
Collapse
Affiliation(s)
- Stéphanie Goncalves
- HAVAE, Limoges University, Department of Physical Activity and Sport Sciences, UR20217, F-87000, France (S.G., S.M.)
| | - Morgane Le Bourvellec
- MOVE, Poitiers University, Faculty of Sport Sciences, UR20296, F-86000, France (M.L.B.)
| | - Stéphane Mandigout
- HAVAE, Limoges University, Department of Physical Activity and Sport Sciences, UR20217, F-87000, France (S.G., S.M.)
- ILFOMER, Limoges University, F-87000, France (S.M.)
| | - Noémie C Duclos
- Bordeaux University, INSERM, BPH, U1219, Team ACTIVE, F-33000, France (N.C.D.)
| |
Collapse
|
5
|
Guo L, Zhang M, Namassevayam G, Wei M, Zhang G, He Y, Guo Y, Liu Y. Effectiveness of health management among individuals at high risk of stroke: An intervention study based on the health ecology model and self-determination theory (HEM-SDT). Heliyon 2023; 9:e21301. [PMID: 37964830 PMCID: PMC10641168 DOI: 10.1016/j.heliyon.2023.e21301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/11/2023] [Accepted: 10/19/2023] [Indexed: 11/16/2023] Open
Abstract
Background Stroke is the second leading cause of death in adults worldwide. However, up to 80% of strokes can be prevented by modifying risk factors. Objective The study aims to assess the effectiveness of the Health Ecology Model and Self-Determination Theory (HEM-SDT) based health management intervention among individuals at high risk of stroke. Methods A randomized controlled trial was conducted in Zhengzhou from May 1st, 2020, to December 31st, 2020. A total of 229 participants were recruited for the study, with 116 individuals at high risk of stroke being randomly assigned to the HEM-SDT health management group, while 113 participants were enrolled in the control group, following their current routine practices. The Generalized Estimating Equation model (GEE) was used to analyze the differences in health knowledge, belief and, behavior between the two groups at the beginning of the intervention, and at 6-month intervals after the intervention. The chi-square test was utilized to assess the control rate of risk factors. Results After 6 months of intervention, there were significant improvements in health knowledge, behavior, and belief among the participants. The study found significant differences in the interaction effects between time and group for health knowledge (Mean, SD = 25.62 ± 3.88, 95%CI: 7.944-9.604, P<0.001), health belief (Mean, SD = 87.18 ± 14.21, 95%CI: 23.999-29.887, P<0.001), and health behavior (Mean, SD = 173.28 ± 24.22, 95%CI: 22.332-36.904, P<0.001). Additionally, the rates of hypertension, hyperglycemia, dyslipidemia, high or medium risk condition of stroke, obesity, hyperhomocysteinemia, smoking, alcohol consumption, and lack of exercise also showed statistical significance (P<0.05) after the intervention. Conclusion The HEM-SDT health management model improves the health knowledge, behavior, and beliefs in people at high risk of stroke and remarkably it shows improvement in modifiable risk factors. It can be recommended for systematic health management in people at high-risk of stroke.
Collapse
Affiliation(s)
- Lina Guo
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Mengyv Zhang
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Genoosha Namassevayam
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Department of Supplementary Health Sciences, Faculty of Health-Care Sciences, Eastern University, Sri Lanka
| | - Miao Wei
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Gege Zhang
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yv He
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Reproductive Medicine Center, Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Yuanli Guo
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yanjin Liu
- Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| |
Collapse
|
6
|
Uhlig-Reche H, Ontiveros D, Syzdek R, Mathews P, Dalal L, Amaro A, Wunnava N, Housammy Z, Schmitt B, Sharrief A, Gonzales NR. Description of Baseline Nutrition and Physical Activity Knowledge and Behavior in Acute Stroke/TIA Patients Enrolled in the Health Education on Information Retention and Behavior Change in Stroke (HERBS) Pilot Trial. Nutrients 2023; 15:3761. [PMID: 37686793 PMCID: PMC10490333 DOI: 10.3390/nu15173761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/24/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Lifestyle modifications after stroke are associated with better risk factor control and lower mortality. The primary objective of this study was to describe the knowledge of American Heart Association (AHA) recommendations for diet and exercise in survivors of stroke and transient ischemic attack (TIA). The secondary objectives were to describe their diet and exercise behaviors, self-efficacy (SE), behavioral intent (BI), stage of change, and barriers to change. Data are described from participants enrolled in a prospective educational intervention in mild stroke/TIA survivors. A multiple-choice questionnaire ascertained knowledge of AHA recommendations for diet and exercise, nutrition and physical activity behavior, SE, BI, stage of change, and barriers to change. Twenty-eight stroke/TIA survivors, with a mean age of 61.7 ± 11.8 years, completed questionnaires during their acute hospitalization. Participants underestimated the recommended intake of fruits, vegetables, whole grains, and participation in aerobic exercise and overestimated the recommended intake of sugar and salt. SE demonstrated a significant positive association with combined behavior scores (rs = 0.36, p = 0.043). Greater knowledge of the AHA recommendations was not associated with healthier behavior, greater SE, higher BI, or more advanced stage of change. The gaps between AHA recommendations and stroke/TIA patient knowledge identifies an area for potential intervention in stroke prevention and recovery.
Collapse
Affiliation(s)
- Hannah Uhlig-Reche
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Diana Ontiveros
- Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC 27514, USA
| | - Riley Syzdek
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA (L.D.); (Z.H.)
| | - Patenne Mathews
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Leanne Dalal
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA (L.D.); (Z.H.)
| | - Andrea Amaro
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75235, USA
| | - Nidhi Wunnava
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Zina Housammy
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA (L.D.); (Z.H.)
| | - Barrie Schmitt
- Department of Neurology, Neurohospitalist & Stroke Section, University of Colorado School of Medicine, Aurora, CO 80045, USA (N.R.G.)
| | - Anjail Sharrief
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Nicole R. Gonzales
- Department of Neurology, Neurohospitalist & Stroke Section, University of Colorado School of Medicine, Aurora, CO 80045, USA (N.R.G.)
| |
Collapse
|
7
|
Oikarinen A, Engblom J, Paukkonen L, Kääriäinen M, Kaakinen P, Kähkönen O. Effects of a lifestyle counselling intervention on adherence to lifestyle changes 7 years after stroke - A quasi-experimental study. Scand J Caring Sci 2023; 37:163-172. [PMID: 35766254 DOI: 10.1111/scs.13101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 06/06/2022] [Accepted: 06/13/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Adherence to medication and healthy lifestyle is crucial for preventing secondary strokes and other vascular events. However, there is not enough evidence on the long-term effects of hospital-initiated lifestyle counselling. AIM To determine the effects of The Risk Factor Targeted Lifestyle Counselling Intervention, which is implemented during acute hospitalisation, on adherence to lifestyle changes 7 years after stroke or TIA. METHODS Quasi-experimental design with 7-year follow-up period. Baseline data (n = 150) were gathered from a neurology unit in Finland between 2010 and 2011. Patients received either the studied intervention (n = 75) or the prevailing form of counselling at the time (n = 75). Data concerning lifestyle and clinical values were measured at the baseline time point, while adherence to lifestyle changes was assessed 7 years later (2017-2018). Analysis of covariance and multivariate ordinal logistic regression were used to describe the mean differences between the intervention and control groups. RESULTS Several between-group differences were detected, namely, members of the intervention group reported consuming less alcohol and having lost more weight during hospitalisation relative to the control group. No between-group differences in the prevalence of smokers were found, but the intervention group reported a greater number of daily cigarettes than the control group. Adherence to medication, importance of adherence to a healthy lifestyle, support from family and friends, and support from nurses were all significantly higher in the intervention group than in the control group. CONCLUSIONS The results suggest that the lifestyle counselling intervention was effective in decreasing alcohol use and weight, as well as increasing factors that are known to support adherence to a healthy lifestyle. RELEVANCE TO CLINICAL PRACTICE The results indicate that the adherence process already begins during acute phase counselling. To ensure long-lasting lifestyle changes, counselling should be started at the hospital, after which it can be provided by friends and family members.
Collapse
Affiliation(s)
- Anne Oikarinen
- Research Unit of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Janne Engblom
- Quantitative Methods in Management, Turku School of Economics University of Turku, Turku, Finland
| | - Leila Paukkonen
- Research Unit of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Oulu, Finland.,Northern Ostrobothnia Hospital District, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Oulu, Finland.,Northern Ostrobothnia Hospital District, Oulu, Finland
| | - Pirjo Kaakinen
- Research Unit of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Outi Kähkönen
- Research Unit of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Oulu, Finland
| |
Collapse
|
8
|
Dubach RA, Tripathi NS. Secondary Stroke Prevention Education: Occupational Therapy Practitioners’ Implementation and Perceptions. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2023. [DOI: 10.1080/02703181.2023.2165593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Rebecca A. Dubach
- Department of Occupational Therapy, College of Nursing and Health Professions, Valparaiso University, Valparaiso, Indiana, USA
| | - Neha S. Tripathi
- Department of Occupational Therapy, College of Nursing and Health Professions, Valparaiso University, Valparaiso, Indiana, USA
| |
Collapse
|
9
|
Oh HX, De Silva DA, Toh ZA, Pikkarainen M, Wu VX, He HG. The effectiveness of self-management interventions with action-taking components in improving health-related outcomes for adult stroke survivors: a systematic review and meta-analysis. Disabil Rehabil 2022; 44:7751-7766. [PMID: 34757862 DOI: 10.1080/09638288.2021.2001057] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE This systematic review and meta-analysis aims to synthesise the evidence of the effectiveness of self-management interventions with action-taking components in improving self-efficacy, health-related quality of life, basic and instrumental activities of daily living, and depression for adult stroke survivors. MATERIALS AND METHODS Nine electronic databases were searched for relevant studies, including grey literature and ongoing studies. Randomised controlled trials targeting adult stroke survivors comparing health-related outcomes of patients receiving self-management interventions with action-taking components to usual care, placebo, or no-treatment were included. Screening, data extraction, and methodological quality assessment were conducted by two reviewers. Meta-analyses were performed. Overall quality of evidence was assessed using the GRADE tool. RESULTS A total of seventeen studies were included. Meta-analyses showed that the intervention may result in a slight increase in self-efficacy (SMD = 0.29, 95% CI [0.07-0.52], p = 0.010, I2 = 47%) and basic activities of daily living (SMD = 0.31, 95% CI [0.16-0.46], p < 0.001, I2 = 0%), but not for the other outcomes. CONCLUSIONS Self-management interventions with action-taking components may result in a slight improvement in self-efficacy and rehabilitation of basic activities of daily living. Future research should investigate which core self-management skill, or combination of them, is most effective in improving short-term and long-term outcomes.IMPLICATIONS FOR REHABILITATIONStroke can be a chronic condition as approximately half of stroke survivors suffer from permanent disabilities.Self-management interventions are one form of rehabilitation programmes available to stroke survivors.Self-management interventions with action-taking components may result in a slight increase in patient self-efficacy and carrying out basic activities of daily living compared to usual care given.
Collapse
Affiliation(s)
- Hui Xian Oh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
| | - Deidre Anne De Silva
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore.,Department of Neurology, Singapore General Hospital, Singapore, Singapore
| | - Zheng An Toh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
| | - Minna Pikkarainen
- Oslomet -Oslo Metropolitan University, Oslo, Norway.,Chalmers University of Technology, Gothenburg, Sweden.,University of Oulu, Oulu, Finland
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
| |
Collapse
|
10
|
Bailey RR, Neri AL, Serra MC. Evidence Surrounding Dietary Behavior Interventions in Community-Dwelling Stroke Survivors: A Scoping Review. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221138080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: To identify and summarize studies that have implemented dietary behavior interventions and reported dietary outcomes in community-dwelling adult stroke survivors. Design: Scoping Review; Setting: Not applicable. Participants: Studies eligible for review included peer-reviewed studies describing both a dietary intervention and a dietary outcome among community-dwelling stroke survivors published between January 2000 and June 2022. Results: We identified 14 articles that included both a dietary behavior intervention and a dietary outcome. All studies (5 pilot randomized controlled trials (RCTs), 6 non-pilot RCTs, 3 cohort studies) delivered multimodal health behavior interventions that included a dietary component. Interventions were delivered weekly to every other month and lasted for 1–24 months. Most studies did not use standardized assessments to assess dietary outcomes; however, 8 studies reported improvement in dietary outcomes. Conclusions: This review provides support for the efficacy of dietary behavior interventions in stroke survivors. Variability in intervention format and assessment measures across studies impedes the ability to conduct meta-analyses of outcomes to inform research knowledge and clinical practice. Additional research is needed to determine mechanisms-of-action for dietary behavior change in stroke survivors.
Collapse
Affiliation(s)
- Ryan R. Bailey
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, UT, USA; School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Geriatric Research Education and Clinical Center, South Texas Veterans Health Care System, San Antonio, TX, USA; Division of Geriatrics, Gerontology & Palliative Medicine and the Sam & Ann Barshop Institute for Longevity & Aging Studies, University of Texas Health Science Center at San Antonio, San Antonio,
| | - Alfonso L. Neri
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, UT, USA; School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Geriatric Research Education and Clinical Center, South Texas Veterans Health Care System, San Antonio, TX, USA; Division of Geriatrics, Gerontology & Palliative Medicine and the Sam & Ann Barshop Institute for Longevity & Aging Studies, University of Texas Health Science Center at San Antonio, San Antonio,
| | - Monica C. Serra
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, UT, USA; School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Geriatric Research Education and Clinical Center, South Texas Veterans Health Care System, San Antonio, TX, USA; Division of Geriatrics, Gerontology & Palliative Medicine and the Sam & Ann Barshop Institute for Longevity & Aging Studies, University of Texas Health Science Center at San Antonio, San Antonio,
| |
Collapse
|
11
|
Bayes J, Peng W, Adams J, Sibbritt D. The effect of the Mediterranean diet on health outcomes in post-stroke adults: a systematic literature review of intervention trials. Eur J Clin Nutr 2022; 77:551-560. [PMID: 36127392 DOI: 10.1038/s41430-022-01212-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Stroke represents a major source of mortality and morbidity worldwide. Guidelines for stroke management and secondary prevention focus on reducing stroke-related risk factors such as smoking cessation, exercise and diet. Several clinical practice guidelines specifically recommend a Mediterranean diet (MD) for individuals with stroke. However, these recommendations rely primarily on observational research. The aim of this review is to critically appraise the current experimental evidence assessing the use of a Mediterranean diet on health outcomes in post-stroke adults. METHODS A systematic literature review was conducted of original research which assessed the role of a Mediterranean diet on health outcomes in post-stroke adults. The following databases were searched: PROQUEST, SCOPUS (Elsevier), MEDLINE (EBSCO), EMBase and Cochrane Library up to the 25th of August 2021. RESULTS A total of 6 studies from a total of 5838 identified studies met the full inclusion criteria and were included in this review. Several different health outcomes were assessed, including blood pathology tests, physical examinations, secondary vascular events and mortality. The Mediterranean diet appears to be beneficial for systolic and diastolic blood pressure, LDL cholesterol, BMI and waist circumference. CONCLUSION This review suggests a Mediterranean diet may be helpful for several health outcomes in post-stroke adults. However, more research is needed to confirm these findings. To ensure robust methodology and replication of results, specific details of the included and excluded foods, quantities and serving sizes should be reported in future research.
Collapse
Affiliation(s)
- Jessica Bayes
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Wenbo Peng
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Jon Adams
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - David Sibbritt
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| |
Collapse
|
12
|
Russell RD, Black LJ, Begley A. Nutrition Education Programs for Adults with Neurological Diseases Are Lacking: A Scoping Review. Nutrients 2022; 14:nu14081577. [PMID: 35458139 PMCID: PMC9030740 DOI: 10.3390/nu14081577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 12/04/2022] Open
Abstract
The nutrition recommendation for most common neurological diseases is to follow national dietary guidelines. This is to mitigate malnutrition, reduce the risk of diet-related diseases, and to help manage some common symptoms, including constipation. Nutrition education programs can support people in adhering to guidelines; hence the aim of this scoping review was to explore what programs have been implemented for adults with neurological diseases. We conducted this review according to a published a priori protocol. From 2555 articles screened, 13 were included (dementia n = 6; multiple sclerosis n = 4; stroke survivors n = 2; Parkinson’s n = 1). There were no programs for epilepsy, Huntington’s, and motor neurone disease. Program duration and number of sessions varied widely; however, weekly delivery was most common. Just over half were delivered by dietitians. Most did not report using a behavior change theory. Commonly used behavior change techniques were instruction on how to perform a behavior, credible source, and behavioral practice/rehearsal. Evidence of nutrition education programs for adults with neurological diseases is lacking. Of those that are published, many do not meet best practice principles for nutrition education regarding delivery, educator characteristics, and evaluation. More programs aligning with best practice principles are needed to assess characteristics that lead to behavior change.
Collapse
Affiliation(s)
- Rebecca D. Russell
- Curtin School of Population Health, Curtin University, Perth, WA 6102, Australia; (R.D.R.); (L.J.B.)
| | - Lucinda J. Black
- Curtin School of Population Health, Curtin University, Perth, WA 6102, Australia; (R.D.R.); (L.J.B.)
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA 6102, Australia
| | - Andrea Begley
- Curtin School of Population Health, Curtin University, Perth, WA 6102, Australia; (R.D.R.); (L.J.B.)
- Correspondence: ; Tel.: +61-8-9266-2773
| |
Collapse
|
13
|
Zuo Y, Li H, Chen S, Tian X, Mo D, Wu S, Wang A. Joint association of modifiable lifestyle and metabolic health status with incidence of cardiovascular disease and all-cause mortality: a prospective cohort study. Endocrine 2022; 75:82-91. [PMID: 34345980 DOI: 10.1007/s12020-021-02832-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/18/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE We aimed to identify the joint associations of modifiable lifestyle and metabolic factors with the incidences of cardiovascular disease and all-cause mortality. METHODS We recruited 94,831 participants (men, 79.76%; median age, 51.60 [43.47-58.87]) without a history of cardiovascular disease from the Kailuan study during 2006 and 2007 and followed them until a cardiovascular disease event, or death occurred, or until December 31, 2017. Baseline metabolic health status was assessed using Adult Treatment Panel III criteria, and details of the lifestyles of the participants were recorded using a self-reported questionnaire. We used Cox proportional hazards models to evaluate the joint associations. RESULTS During a median follow-up of 11.03 years, we recorded 6590 cardiovascular disease events and 9218 all-cause mortality. Participants with the most metabolic risk components and the least healthy lifestyle had higher risk of cardiovascular disease (hazard ratio 2.06 [95% confidence interval (CI) 1.77-2.39]) and mortality (HR 1.53 [95% CI 1.31-1.78]), than participants with fewer metabolic risk components and the healthiest lifestyle. Compared with those in participants with the healthiest lifestyle, the HRs for cardiovascular disease in participants with the least healthy lifestyle were 1.26 (95% CI 1.17-1.37), 1.16 (95% CI 1.03-1.31), and 1.07 (95% CI 0.90-1.27) for those with low, medium, and high metabolic risk, respectively. CONCLUSION Healthy lifestyle is associated with a lower risk of cardiovascular disease and there is no significant interaction between metabolic risk and a healthy lifestyle. Therefore, a healthy lifestyle should be promoted, even for people with high metabolic risk.
Collapse
Affiliation(s)
- Yingting Zuo
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Haibin Li
- Department of Cardiac Surgery, Heart Center, and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xue Tian
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Dapeng Mo
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
| | - Anxin Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
14
|
Bailey RR, Ipsen M. Facilitators and barriers to performing dietary behaviors among chronic community-dwelling stroke survivors: A qualitative secondary analysis. Disabil Health J 2022; 15:101270. [DOI: 10.1016/j.dhjo.2022.101270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 11/03/2022]
|
15
|
Sakakibara BM, Lear SA, Barr SI, Goldsmith CH, Schneeberg A, Silverberg ND, Yao J, Eng JJ. Telehealth coaching to improve self-management for secondary prevention after stroke: A randomized controlled trial of Stroke Coach. Int J Stroke 2021; 17:455-464. [PMID: 33949270 DOI: 10.1177/17474930211017699] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Stroke Coach is a lifestyle coaching telehealth program to improve self-management of stroke risk factors. AIMS To examine the efficacy of Stroke Coach on lifestyle behavior and risk factor control among community-living stroke survivors within one-year post stroke. METHODS Participants were randomized to Stroke Coach or an attention control Memory Training group. Lifestyle behavior was measured using the Health Promoting Lifestyle Profile II. Secondary outcomes included specific behavioral and cardiometabolic risk factors, health-related quality of life (HRQoL), cognitive status, and depressive symptoms. Measurements were taken at baseline, post-intervention (6 months), and retention (12 month). Linear mixed-effects models were used to test the study hypotheses (p < 0.05). All analyses were intention-to-treat. RESULTS The mean age of the Stroke Coach (n = 64) and Memory Training (n = 62) groups was 67.2 and 69.1 years, respectively. The majority of participants (n = 100) had mild stroke (modified Rankin Scale = 1 or 2), were active, with controlled blood pressure (mean = 129/79 mmHg) at baseline. At post-intervention, there were no significant differences in lifestyle (b = -2.87; 95%CI - 8.03 to 2.29; p = 0.28). Glucose control, as measured by HbA1c (b = 0.17; 95%CI 0.17 to 0.32; p = 0.03), and HRQoL, measured using SF-36 Physical Component Summary (b = -3.05; 95%CI -5.88 to -0.21; p = 0.04), were significantly improved in Stroke Coach compared to Memory Training, and the improvements were maintained at retention. CONCLUSION Stroke Coach did not improve lifestyle behavior; however, there were improvements to HbA1c and HRQoL among community-living stroke survivors with mild stroke-related disability. (ClinicalTrials.gov identifier: NCT02207023).
Collapse
Affiliation(s)
- Brodie M Sakakibara
- Department of Physical Therapy, 8166The University of British Columbia, Vancouver, Canada
- Faculty of Health Sciences, 1763Simon Fraser University, Burnaby, Canada
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Scott A Lear
- Faculty of Health Sciences, 1763Simon Fraser University, Burnaby, Canada
- Division of Cardiology, Providence Health Care, Vancouver, Canada
| | - Susan I Barr
- Food, Nutrition & Health, 8166The University of British Columbia, Vancouver, Canada
| | - Charlie H Goldsmith
- Faculty of Health Sciences, 1763Simon Fraser University, Burnaby, Canada
- Department of Occupational Science and Occupational Therapy, 8166The University of British Columbia, Vancouver, Canada
| | - Amy Schneeberg
- Department of Physical Therapy, 8166The University of British Columbia, Vancouver, Canada
| | - Noah D Silverberg
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, Canada
- Division of Physical Medicine and Rehabilitation, 8166The University of British Columbia, Vancouver, Canada
- Department of Psychology, 8166The University of British Columbia, Vancouver, Canada
| | - Jennifer Yao
- Division of Physical Medicine and Rehabilitation, 8166The University of British Columbia, Vancouver, Canada
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, Canada
| | - Janice J Eng
- Department of Physical Therapy, 8166The University of British Columbia, Vancouver, Canada
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, Canada
| |
Collapse
|