Proceedings of The Physiological Society
University of Oxford (2011) Proc Physiol Soc 23, PC320
The effect of a health enhancing physical activity programme on transient ischaemic attack and non-disabling stroke: The methodological design of a randomised controlled pilot trial.
J. Faulkner1, G. McGonigal2
1. School of Sport & Exercise, Massey University, Wellington, New Zealand. 2. Wellington Regional Hospital, Capital and Coast District Health Board, Wellington, United Kingdom.
A transient ischaemic attack (TIA) is a brief episode of neurological dysfunction caused by a focal disturbance of brain ischaemia lasting less than 24 hours (Wu et al., 2007). TIA offers a warning sign for subsequent stroke as ~15% of ischaemic strokes are preceded by a TIA (Wu et al., 2007). For patients diagnosed with a TIA, management strategies are predominantly aligned with lifestyle (i.e., advice on smoking cessation, diet) and pharmacological interventions (Manktelow & Potter, 2009). Coronary Heart Disease (CHD) and Cerebrovascular Disease (CVD) share many predisposing, modifiable risk factors (hypertension, abnormal blood lipids, cigarette smoking, physical inactivity, obesity). Research has shown the benefits of exercise programmes and lifestyle education for individuals with CHD (Jolifee et al., 2010). There is, however, the need to establish and identify the feasibility and efficacy of exercise-based interventions for CVD (Lennon & Blake, 2009; Yang et al. 2010). With mounting evidence highlighting the multifactorial pathogenesis of CVD, an early treatment strategy of the underlying disease process, incorporating physical activity participation, may be an effective approach towards preventing recurrent vascular events. The purpose of the present study is therefore to examine whether a ‘Health Enhancing Physical Activity Programme’ (HEPAP; exercise & education) reduces risk factors aligned with CVD, improves physical fitness, and increases the awareness of educational and health issues associated with TIA. In this study, 60 patients will be screened for TIA at Wellington Hospital (NZ). All recruited participants will complete a baseline assessment incorporating a risk stratification assessment, exercise ECG stress test, submaximal cycle test and a series of psychosocial lifestyle focused questionnaires (HADS, POMS, SF-36, etc). Participants are then randomized to either an eight week HEPAP (n = 30) or a ‘normal care’ control group (n = 30). The HEPAP will incorporate aerobic and resistance exercises, flexibility and co-ordination / balance-based exercises, with an additional educational component (goal setting, advice on smoking cessation, diet, physical activity and coping with TIA etc), which will be performed in small groups, twice a week (90 min sessions). A further home-based exercise session will also be incorporated into the programme each week. Immediate post-intervention, 3-month and 12 month follow-up assessments will be undertaken (identical to baseline). This pilot study is ethically approved by the ‘Central Regional Ethics Committee’ and is funded by the Massey University Research Fund. Data collection commenced w/c 14th February 2011, and provisional findings will be presented at the Physiological Society Conference.
Where applicable, experiments conform with Society ethical requirements