Non-pharmacological interventions for preventing secondary vascular events after stroke or transient ischemic attack

MacKay‐Lyons, Marilyn; Thornton, Marianne; Ruggles, Tim; Che, Marion

doi:10.1002/14651858.cd008656.pub2

Cited by 35 publications

(27 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…803 A multifaceted approach that combines nonpharmacological interventions (ie, exercise, dietary advice, lifestyle counseling, and patient education) and appropriate pharmacological therapy has been encouraged, 805 but the effectiveness of specific nonpharmacological components remains to be investigated. 806 Pilot studies of second stroke prevention using a cardiac rehabilitation approach have demonstrated a reduction in cardiac risk scores 807 and improvements in total cholesterol, body composition, and resting blood pressure, 808 but these results must be confirmed in larger, controlled trials. Despite a lack of robust evidence, exercise and physical activity are regarded as key components of comprehensive stroke risk-reduction efforts.…”

Section: Winstein Et Al Guidelines For Adult Stroke Rehabilitation Anmentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

Self Cite

2,187

840

View full text Add to dashboard Cite

e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

show abstract

Section: Winstein Et Al Guidelines For Adult Stroke Rehabilitation Anmentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

Self Cite

2,187

840

View full text Add to dashboard Cite

show abstract

“…The second review analyzed the effectiveness of multi-dimensional, non-pharmacological interventions used in cardiac rehabilitation including aerobic training, dietary advice or nutritional strategies, verbal or written patient education, and/or lifestyle counseling delivered by health professionals or other personnel and compared these with usual care in preventing secondary vascular events and reducing vascular risk after index stroke or TIA. 6 Only one study was identified that met inclusion criteria involving 48 participants in a 10-week pilot cardiac rehabilitation program for post-stroke patients, and showed that patients after stroke had significantly greater improvement in a standardized cardiac risk score. The third review focused on physical fitness training for mostly ambulatory stroke patients and included 58 trials with a total of 2797 participants at all stages of care after stroke up through February 2015.…”

Section: Behavioral Interventions In Strokementioning

confidence: 99%

Behavioral Interventions for Stroke Prevention

Salinas

Schwamm

2017

Stroke

View full text Add to dashboard Cite

“…Evidence is growing regarding the contribution of change in modifiable risk factors to reductions in cardiovascular deaths,32 and there is a need to consider how to promote non-pharmacological measures in secondary prevention 33. Indeed, five modifiable risk factors are reported to account for 82% of strokes: hypertension, smoking, obesity, unhealthy diet, and physical inactivity 34.…”

Section: Discussionmentioning

confidence: 99%

Secondary prevention lifestyle interventions initiated within 90 days after TIA or ‘minor’ stroke: a systematic review and meta-analysis of rehabilitation programmes

Heron¹,

Kee²,

Cardwell³

et al. 2016

Br J Gen Pract

View full text Add to dashboard Cite

BackgroundStrokes are often preceded by a transient ischaemic attack (TIA) or ‘minor’ stroke. The immediate period after a TIA/minor stroke is a crucial time to initiate secondary prevention. However, the optimal approach to prevention, including non-pharmacological measures, after TIA is not clear.AimTo systematically review evidence about the effectiveness of delivering secondary prevention, with lifestyle interventions, in comprehensive rehabilitation programmes, initiated within 90 days of a TIA/minor stroke. Also, to categorise the specific behaviour change techniques used.Design and settingThe review identified randomised controlled trials by searching the Cochrane Library, Ovid MEDLINE, Ovid EMBASE, Web of Science, EBSCO CINAHL and Ovid PsycINFO.MethodTwo review authors independently screened titles and abstracts for eligibility (programmes initiated within 90 days of event; outcomes reported for TIA/minor stroke) and extracted relevant data from appraised studies; a meta-analysis was used to synthesise the results.ResultsA total of 31 potentially eligible papers were identified and four studies, comprising 774 patients post-TIA or minor stroke, met the inclusion criteria; two had poor methodological quality. Individual studies reported increased aerobic capacity but meta-analysis found no significant change in resting and peak systolic blood pressure, resting heart rate, aerobic capacity, falls, or mortality. The main behaviour change techniques were goal setting and instructions about how to perform given behaviours.ConclusionThere is limited evidence of the effectiveness of early post-TIA rehabilitation programmes with preventive lifestyle interventions. Further robust randomised controlled trials of comprehensive rehabilitation programmes that promote secondary prevention and lifestyle modification immediately after a TIA are needed.

show abstract

Non-pharmacological interventions for preventing secondary vascular events after stroke or transient ischemic attack

Cited by 35 publications

References 46 publications

Guidelines for Adult Stroke Rehabilitation and Recovery

Guidelines for Adult Stroke Rehabilitation and Recovery

Behavioral Interventions for Stroke Prevention

Secondary prevention lifestyle interventions initiated within 90 days after TIA or ‘minor’ stroke: a systematic review and meta-analysis of rehabilitation programmes

Contact Info

Product

Resources

About