Repeated Encouragement Fails To Increase Physical Activity After Stroke

Repeated encouragement and verbal instruction do not motivate stroke survivors to be physically active, and other more intensive strategies need to be found, concludes a study published on bmj.com today.

It is well known that even moderate physical activity can reduce the risk of cardiovascular disease and first stroke and physical exercise is also recommended for stroke survivors. Counseling on physical activity can motivate some elderly sedentary people to improve their level of physical activity, and previous studies have shown that physical activity can improve balance, walking ability and fitness in stroke patients.

But little is known about which interventions to promote physical activity in stroke survivors are effective.

So Professor Gudrun Boysen and her team carried out a randomized trial to examine if the low-cost intervention of repeated encouragement and verbal instructions on how to exercise could persuade stroke patients to be more physically active in the long-term.

They recruited 314 stroke patients aged 40 years or older from four stroke centers in Denmark, China, Poland, and Estonia and randomized them to receive either an instructed training programme from a physiotherapist to promote physical activity prior to discharge and at six follow-up visits, or to follow-up visits with no instructions about physical activity.

Levels of physical activity were measured using the Physical Activity Scale for the Elderly (PASE) including walking, light sport, housework and working. A higher score represented a higher level of activity.

Findings showed that repeated encouragement and verbal instruction did not result in a measurable increase in physical activity. Mean PASE scores were 69.1 in the intervention group and 64.0 in the control group. In addition, the intervention had no significant effect on death, recurrent stroke, heart attacks, or falls or fractures.

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Our results show that stroke patients are: “Inclined to low levels of physical activity…and more intensive strategies seem to be needed to promote physical activity after ischemic stroke,” conclude the authors.

Source-BMJ
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