Secondary prevention of stroke. A telehealth-delivered physical activity and diet pilot randomized trial (ENAbLE-pilot)

Int J Stroke. 2024 Feb;19(2):199-208. doi: 10.1177/17474930231201360. Epub 2023 Sep 29.

Abstract

Background: Improving physical activity levels and diet quality are important for secondary stroke prevention.

Aim: To test the feasibility and safety of 6-month, co-designed telehealth-delivered interventions to increase physical activity and improve diet quality.

Methods: A 2 × 2 factorial trial (physical activity (PA); diet (DIET); PA + DIET; control) randomized, open-label, blinded endpoint trial. Primary outcomes were feasibility and safety. Secondary outcomes included stroke risk factors (blood pressure, self-report PA (International Physical Activity Questionnaire (IPAQ)) and diet quality (Australian Recommended Food Score (ARFS)), and quality of life. Between-group differences were analyzed using linear-mixed models.

Results: Over 23 months, 99 people were screened for participation and 40 (40%) randomized (3 months to 10 years post-stroke, mean age 59 (16) years). Six participants withdrew, and an additional five were lost to follow-up. Fifteen serious adverse events were reported, but none were deemed definitely or probably related to the intervention. Median attendance was 32 (of 36) PA sessions and 9 (of 10) DIET sessions. The proportion of missing primary outcome data (blood pressure) was 3% at 3 months, 11% at 6 months, and 14% at 12 months. Between-group 95% confidence intervals showed promising, clinically relevant differences in support of the interventions across the range of PA, diet quality, and blood pressure outcomes.

Conclusion: Our telehealth PA and diet interventions were safe and feasible and may have led to significant behavior change.

Trial registration: ACTRN12620000189921.

Keywords: Physical activity; blood pressure; diet; pilot trial; quality of life; telehealth.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Australia
  • Diet
  • Exercise
  • Humans
  • Middle Aged
  • Pilot Projects
  • Quality of Life
  • Secondary Prevention
  • Stroke* / prevention & control
  • Telemedicine*