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Potential effects on cardiometabolic risk factors and body composition by short message service (SMS)-guided training after recent minor stroke or transient ischaemic attack: Post hoc analyses of the STROKEWALK randomised controlled trial
Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala Universitet Medicinska Fakulteten, Uppsala, Sweden.
Department of Neuroscience, Uppsala Universitet Medicinska Fakulteten, Uppsala, Sweden.
Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi. Centre for Clinical Research, Eskilstuna, Sweden.
Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala Universitet Medicinska Fakulteten, Uppsala, Sweden.
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2021 (Engelska)Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 11, nr 10, artikel-id e054851Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives: To evaluate effects of mobile phone text-messaging exercise instructions on body composition, cardiometabolic risk markers and self-reported health at 3 months after stroke.

Design: Randomised controlled intervention study with per-protocol analyses.

Setting: University Hospital in Sweden.

Participants: Seventy-nine patients (mean (SD) age 64 (10) years, 37% female) ≥18 years with good motor function (modified Rankin Scale ≤2) and capable to perform 6 min walking test at hospital discharge were randomised to either intervention (n=40) or control group (n=39). Key exclusion criteria: Subarachnoid bleeding, uncontrolled hypertension, severe psychiatric problems or cognitive limitations.

Interventions: The intervention group received beyond standard care, daily mobile phone instructional text messages to perform regular outdoor walking and functional leg exercises. The control group received standard care.

Main outcome measures: Fat mass and fat-free mass were estimated by bioelectric impedance analysis. Cardiometabolic risk factors like blood lipids, glycated haemoglobin and blood glucose were analysed at baseline and after 3 months.

Results: Both groups changed favourably in fat-free mass (1.83 kg, 95% CI 0.77 to 2.89; p=0.01, effect size (ES)=0.63 vs 1.22 kg, 95% CI 0.39 to 2.0; p=0.05, ES=0.54) and fat mass (-1.30 kg, 95% CI-2.45 to-0.14; p=0.029, ES=0.41 vs-0.76 kg, 95% CI-1.74 to 0.22; p=0.123, ES=0.28). Also, many cholesterol related biomarkers improved; for example, total cholesterol-0.65 mmol/L, 95% CI-1.10 to-0.2; p=0.06, ES: 0.5 vs-1.1 mmol/L, 95% CI-1.47 to-0.56; p>0.001, ES=0.8. However, there were no between-group differences. At 3 months, 94% and 86%, respectively, reported very good/fairly good health in the text messaging and control groups.

Conclusions: No clear effect of 3 months daily mobile phone delivered training instructions was detected on body composition, cardiovascular biochemical risk factors or self-perceived health. Further research is needed to evaluate secondary prevention efforts in larger populations after recent stroke.

Trial registration number: NCT02902367.

Ort, förlag, år, upplaga, sidor
BMJ Publishing Group Ltd, 2021. Vol. 11, nr 10, artikel-id e054851
Nyckelord [en]
neurology, rehabilitation medicine, rehabilitation medicine, stroke, stroke medicine
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Allmänmedicin
Identifikatorer
URN: urn:nbn:se:umu:diva-191155DOI: 10.1136/bmjopen-2021-054851ISI: 000709009700001PubMedID: 34663672Scopus ID: 2-s2.0-85117802076OAI: oai:DiVA.org:umu-191155DiVA, id: diva2:1626061
Forskningsfinansiär
STROKE-RiksförbundetTillgänglig från: 2022-01-10 Skapad: 2022-01-10 Senast uppdaterad: 2023-08-28Bibliografiskt granskad

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