title: The effectiveness of a comprehensive reminder system in the secondary prevention of hypertensive ischaemic stroke: randomized controlled trial protocol. What's in a name? The challenge of describing interventions in systematic reviews: analysis of a random sample of reviews of non-pharmacological stroke interventions Impact of Time on Improvement of Outcome After Stroke Treadmill Aerobic Training Improves Glucose Tolerance and Indices of Insulin Sensitivity in Disabled Stroke Survivors: A Preliminary Report Too much sitting: the population health science of sedentary behavior. A randomized controlled trial of supervised versus unsupervised exercise programs for ambulatory stroke survivors. Factors Influencing Engagement, Perceived Usefulness and Behavioral Mechanisms Associated with a Text Message Support Program Movement as Medicine for Type 2 Diabetes: protocol for an open pilot study and external pilot clustered randomised controlled trial to assess acceptability, feasibility and fidelity of a multifaceted behavioural intervention targeting physical activity in primary care Effects of Resistance Training and Aerobic Training on Ambulation in Chronic Stroke Targeting motivation and self-regulation to increase physical activity among patients with rheumatoid arthritis: a randomised controlled trial Validation of a new self-report instrument for measuring physical activity. Implementation of a stroke self-management program Circuit-based rehabilitation improves gait endurance but not usual walking activity in chronic stroke: a randomized controlled trial. The Effects of “Physical Activity on Prescription” in Persons With Transient Ischemic Attack: A Randomized Controlled Study Reducing Sitting Time After Stroke: A Phase II Safety and Feasibility Randomized Controlled Trial. The effect of early aerobic training on independence six months post stroke Ratings of Perceived Exertion in Active Muscle During High‐Intensity and Low‐Intensity Resistance Exercise Promoting physical activity after stroke via self-management: a feasibility study
abstract: AIM The aim of this study was to determine whether the Comprehensive Reminder System based on the Health Belief Model improves health belief , health behaviours , medication adherence and blood pressure control as a means of decreasing the rate of stroke recurrence among hypertensive ischaemic stroke . BACKGROUND Hypertensive patients having experienced recent ischaemic strokes are at high risk for stroke recurrence . Several trials attempted to improve secondary stroke prevention via patient education , however , patient outcomes remained poor . Long-term follow-up studies regarding secondary stroke prevention are limited . DESIGN A multi-centre , 12-month , assessor-blinded , parallel-group , r and omized controlled longitudinal trial . METHODS Hypertensive patients having experienced an ischaemic stroke are the target population . The intervention consists of health belief education , a calendar h and book , a weekly automated short-message service and four telephone follow-up interviews . Outcomes will be assessed at baseline and at 3 , 6 and 12 months following discharge . The primary outcome is blood pressure control . The secondary outcomes include health belief , health behaviours and medication adherence . The clinical endpoint is the rate of stroke recurrence . DISCUSSION Although many efforts to improve secondary stroke prevention have been undertaken , research indicates that improvements remain possible and warranted . This research protocol based on the Health Belief Model will improve our underst and ing of stroke education and transitional care needed in China and with the world-wide target population Objective To assess , in a sample of systematic review s of non-pharmacological interventions , the completeness of intervention reporting , identify the most frequently missing elements , and assess review authors ’ use of and beliefs about providing intervention information . Design Analysis of a r and om sample of systematic review s of non-pharmacological stroke interventions ; online survey of review authors . Data sources and study selection The Cochrane Library and PubMed were search ed for potentially eligible systematic review s and a r and om sample of these assessed for eligibility until 60 ( 30 Cochrane , 30 non-Cochrane ) eligible review s were identified . Data collection In each review , the completeness of the intervention description in each eligible trial ( n=568 ) was assessed by 2 independent raters using the Template for Intervention Description and Replication ( TIDieR ) checklist . All review authors ( n=46 ) were invited to complete a survey . Results Most review s were missing intervention information for the majority of items . The most incompletely described items were : modifications , fidelity , material s , procedure and tailoring ( missing from all interventions in 97 % , 90 % , 88 % , 83 % and 83 % of review s , respectively ) . Items that scored better , but were still incomplete for the majority of review s , were : ‘ when and how much ’ ( in 31 % of review s , adequate for all trials ; in 57 % of review s , adequate for some trials ) ; intervention mode ( in 22 % of review s , adequate for all trials ; in 38 % , adequate for some trials ) ; and location ( in 19 % of review s , adequate for all trials ) . Of the 33 ( 71 % ) authors who responded , 58 % reported having further intervention information but not including it , and 70 % tried to obtain information . Conclusions Most focus on intervention reporting has been directed at trials . Poor intervention reporting in stroke systematic review s is prevalent , compounded by poor trial reporting . Without adequate intervention descriptions , the conduct , usability and interpretation of review s are restricted and therefore , require action by trialists , systematic review ers , peer review ers and editors Background and Purpose — Longitudinal conducted studies show that neurologic and functional recovery show faster recovery in the first weeks poststroke . The aim of the present study was to study the effects of progress of time on observed improvements in motor strength , synergisms , and activities during the first 16 weeks poststroke . Methods — Based on data from a previous study , 101 patients with first-ever ischemic middle cerebral artery strokes were prospect ively investigated during the first 16 weeks after stroke . Progress of time was categorized into 8 biweekly time intervals and was used as the independent covariate in a first-order longitudinal regression model . The biweekly time change ( progress of time ) was related to improvement in upper and lower limb motor recovery assessed with Fugl-Meyer score and Motricity Index , reduction in visuospatial inattention based on the letter cancellation task , and improvement in walking ability , dexterity , and activities of daily living measured with the Functional Ambulation Categories , Action Research Arm test , and Barthel Index . Results — Time explained a significant change of 8.4 ( 42 % ) measurement units on the Barthel Index for the first 10 weeks poststroke , 1.1 ( 22 % ) measurement units on Functional Ambulation Categories , and 19 % on the Action Research Arm test for the first 6 and 8 weeks poststroke . Approximately 25 % ( for Fugl-Meyer – arm ) to 26 % ( for Motricity Index – arm ) of the significant change in measurements units was explained by time alone for the upper limb compared with 33 % for Fugl-Meyer – leg and 39 % for Motricity Index – leg of the lower limb . Time accounted for a reduction of 16 % in the letter cancellation task . Observed associations did not change after controlling for covariates such as age , gender , hemisphere of stroke , type of stroke , or intervention . Conclusion — Progress of time is an independent covariate that reflects spontaneous recovery of body functions and activities explaining ≈16 % to 42 % of the observed improvements in the first 6 to 10 weeks after stroke onset Background and Purpose — Insulin resistance and glucose intolerance are highly prevalent after stroke , contributing to worsening cardiovascular disease risk and a predisposition to recurrent stroke . Treadmill exercise training ( T-AEX ) increases aerobic capacity ( Vo2 peak ) in chronic stroke patients , suggesting intensity levels that may be adequate to improve glucose metabolism . We compared the effects of a progressive T-AEX intervention to an attention-matched stretching intervention ( CONTROL ) on glucose tolerance and indices of insulin sensitivity in stroke survivors . Methods — Participants had hemiparetic gait after remote ( > 6 months ) ischemic stroke . They were r and omized to 6-month T-AEX or a duration matched reference CONTROL program of supervised stretching exercises . Main outcome measures were glucose and insulin responses during a 3-hour oral glucose tolerance test ( OGTT ) . Results — Forty-six subjects ( T-AEX=26 , CONTROL=20 ) completed OGTT testing before and after the interventions . T-AEX  increased Vo2 peak ( + 15 % versus −3 % & Dgr ; , P<0.01 ) compared with CONTROL . There were significant reductions in fasting insulin ( −23 % versus + 9 % & Dgr ; , P<0.05 ) and the total integrated 3-hour insulin response ( −24 % versus + 3 % & Dgr ; , P<0.01 ) in T-AEX compared with CONTROL . In patients with abnormal glucose tolerance at baseline , T-AEX result ed in a significant 14 % decrease in 3-hour glucose response ( n=12 , P<0.05 ) . Fifty-eight percent of T-AEX participants with abnormal baseline OGTT ( 7 of 12 ) improved glucose tolerance status at 2 hours compared with < 10 % ( 1 of 11 ) of impaired CONTROLS ( P<0.05 ) . Conclusions — These preliminary findings suggest that progressive aerobic exercise can reduce insulin resistance and prevent diabetes in hemiparetic stroke survivors . Larger clinical trials are needed to definitively establish the use of structured exercise training for stimulating metabolic improvement poststroke Even when adults meet physical activity guidelines , sitting for prolonged periods can compromise metabolic health .  Television ( TV ) time and objective measurement studies show deleterious associations , and breaking up sedentary time is beneficial .  Sitting time , TV time , and time sitting in automobiles increase premature mortality risk . Further evidence from prospect i ve studies , intervention trials , and population -based behavioral studies is required BACKGROUND AND PURPOSE Little is known about the relative efficacy of supervised versus unsupervised community exercise programs for stroke survivors . This study compared the effectiveness of a 10-week supervised strengthening and conditioning program ( supervised ) with a 1-week supervised instruction program followed by a 9-week unsupervised home program ( unsupervised ) and evaluated retention of changes at 6 months and 1 year after program completion . METHODS Seventy-two subjects retained at baseline ( 27 women , 45 men ; mean+/-SD age , 64.6+/-11.8 years ) were r and omly allocated to receive the supervised or unsupervised program . The primary outcome was walking speed over 6 minutes , and secondary outcome measures were Human Activity Profile , Medical Outcome Study 36-Item Short-Form survey ( SF-36 ) , Physiological Cost Index , and lower extremity muscle strength . RESULTS The 6-minute walking speed increased significantly in both groups and remained significantly improved by 1 year . The Human Activity Profile demonstrated an increasing trend only in the supervised group that was significant by 1 year . The SF-36 Physical Component summary score increased significantly in the supervised group and remained improved by 1 year ; the unsupervised group showed significant improvement at 1 year . Women made greater gains in supervised programs , but men made greater gains in unsupervised programs . CONCLUSIONS Supervised exercise programs and unsupervised programs after initial supervised instruction were both associated with physical benefits that were retained for 1 year , although supervised programs showed trends to greater improvements in self-reported gains . Gender differences require further research Introduction Many studies have now demonstrated the efficacy of text messaging in positively changing behaviours . We aim ed to identify features and factors that explain the effectiveness of a successful text messaging program in terms of user engagement , perceived usefulness , behavior change and program delivery preferences . Methods Mixed methods qualitative design combining four data sources ; ( i ) analytic data extracted directly from the software system , ( ii ) participant survey , ( iii ) focus groups to identify barriers and enablers to implementation and mechanisms of effect and ( iv ) recruitment screening logs and text message responses to examine engagement . This evaluation was conducted within the TEXT ME trial — a parallel design , single-blind r and omized controlled trial ( RCT ) of 710 patients with coronary heart disease ( CHD ) . Qualitative data were interpreted using inductive thematic analysis . Results 307/352 ( 87 % response rate ) of recruited patients with CHD completed the program evaluation survey at six months and 25 participated in a focus group . Factors increasing engagement included ( i ) ability to save and share messages , ( ii ) having the support of providers and family , ( iii ) a feeling of support through participation in the program , ( iv ) the program being initiated close to the time of a cardiovascular event , ( v ) personalization of the messages , ( vi ) opportunity for initial face-to-face contact with a provider and ( vii ) that program and content was perceived to be from a credible source . Clear themes relating to program delivery were that diet and physical activity messages were most valued , four messages per week was ideal and most participants felt program duration should be provided for at least for six months or longer . Conclusions This study provides context and insight into the factors influencing consumer engagement with a text message program aim ed at improving health-related behavior . The study suggests program components that may enhance potential success but will require integration at the development stage to optimize up-scaling . Trial Registration Australia and New Zeal and Clinical Trials Registry , ACTRN12611000161921 Background Physical activity ( PA ) and nutrition are the cornerstones of diabetes management . Several review s and meta-analyses report that PA independently produces clinical ly important improvements in glucose control in people with Type 2 diabetes . However , it remains unclear what the optimal strategies are to increase PA behaviour in people with Type 2 diabetes in routine primary care . Methods This study will determine whether an evidence -informed multifaceted behaviour change intervention ( Movement as Medicine for Type 2 Diabetes ) targeting both consultation behaviour of primary healthcare professionals and PA behaviour in adults with Type 2 diabetes is both acceptable and feasible in the primary care setting . An open pilot study conducted in two primary care practice s ( phase one ) will assess acceptability , feasibility and fidelity . Ongoing feedback from participating primary healthcare professionals and patients will provide opportunities for systematic adaptation and refinement of the intervention and study procedures . A two-arm parallel group clustered pilot r and omised controlled trial with patients from participating primary care practice s in North East Engl and will assess acceptability , feasibility , and fidelity of the intervention ( versus usual clinical care ) and trial processes over a 12-month period . Consultation behaviour involving fidelity of intervention delivery , diabetes and PA related knowledge , attitudes/beliefs , intentions and self-efficacy for delivering a behaviour change intervention targeting PA behaviour will be assessed in primary healthcare professionals . We will rehearse the collection of outcome data ( with the focus on data yield and quality ) for a future definitive trial , through outcome assessment at baseline , one , six and twelve months . An embedded qualitative process evaluation and treatment fidelity assessment will explore issues around intervention implementation and assess whether intervention components can be reliably and faithfully delivered in routine primary care . Discussion Movement as Medicine for Type 2 Diabetes will address an important gap in the evidence -base , that is , the need for interventions to increase free-living PA behaviour in adults with Type 2 diabetes . The multifaceted intervention incorporates an online accredited training programme for primary healthcare professionals and represents , to the best of our knowledge , the first of its kind in the United Kingdom . This study will establish whether the multifaceted behavioural intervention is acceptable and feasible in routine primary care . Trial registration Movement as Medicine for Type 2 Diabetes ( MaMT2D ) was registered with Current Controlled Trials on the 14th January 2012 : IS RCT N67997502 . The first primary care practice was r and omised on the 5th October 2012 Objective The aim of this study was to directly compare the effects of aerobic training ( AT ) with progressive resistance training ( RT ) after stroke to determine whether AT-induced fitness gains or RT-induced strength gains translate into improved ambulation across a 12-wk intervention and whether gains are retained 1 yr after cessation of formal training . Design This study is a r and omized controlled 12-wk intervention trial with a 1-yr follow-up . Forty-three community-dwelling independent walkers with a chronic ischemic hemiparetic stroke were allocated to AT using a cycle ergometer ( n = 13 ) , RT using training machines ( n = 14 ) , or low-intensity sham training of the arms ( n = 16 ) . The main outcome measures were 6-min walk distance and fast 10-m walking speed . Results Comparisons between AT , RT , and sham training revealed no clinical ly relevant effects on walking velocity or walking distance . Muscle strength improved after RT ( P < 0.0001 ) and was preserved at 1-yr follow-up ( P < 0.001 ) . Aerobic capacity increased after AT ( P < 0.001 ) but was lost during the follow-up observation period . Conclusions Improvement of muscle strength or aerobic capacity using non – task-specific training methods does not result in improved ambulation in patients with chronic stroke .  Muscle strength gains were maintained at follow-up , whereas all improvements of aerobic capacity were lost , indicating a long-lasting effect of intensive RT even without maintenance training The purpose of this study is to evaluate the effects of targeting both the motivation and action phases of behaviour change in a 5-week intervention to increase physical activity ( PA )  among patients with rheumatoid arthritis ( RA ) not meeting current PA recommendations . In a r and omised controlled trial , a control group — which received a group-based patient education session led by a physical therapist — was compared to a treatment group which received the education session plus a motivational interview from a physical therapist and two self-regulation coaching sessions from a rheumatology nurse . Outcomes included  leisure-time PA , days per week with at least 30 min of moderate-intensity PA , self-efficacy and autonomous motivation ( cognitions which predict PA initiation and maintenance ) , disease activity , functional status , depressive symptoms and fatigue . Effects were assessed using mixed models repeated measures . Of the 78 patients r and omised , 76 and 67 completed the post-treatment and follow-up assessment s , respectively . Significant treatment effects were found for leisure-time PA  ( p = 0.022 ) , active days/week ( p = 0.016 ) , self-efficacy ( p = 0.008 ) and autonomous motivation ( p = 0.001 ) . At post-treatment and 6-months follow-up , significantly more treated patients than controls met current PA recommendations . No significant effects were found for disease activity , functional status , depressive symptoms or fatigue . Combining motivation- and action-focused intervention approaches improved PA-related cognitions and led to improved uptake and maintenance of leisure-time PA . However , further research is necessary to identify ways of helping patients with RA transition to— and maintain — more intensive forms of PA which are more likely to improve disease activity and functional status PURPOSE Development and validation of a physical activity scale for measuring physical activity in 24 h of sports , work , and leisure time on an average weekday . METHODS For development of the physical activity scale , 2500 r and omly selected Danish men and women between the age of 20 and 60 were contacted by mail and asked to select frequent and relevant physical activities from a number of activities of known MET intensity . The activities were included in the physical activity scale , organized in nine different MET levels ranging from sleep/rest ( 0.9 METs ) to high-intensity physical activities ( > 6 METs ) . Face validity of the physical activity scale was explored through interviews with 10 volunteer men and women .  Concurrent validity was assessed against 4 d of accelerometry ( CSA 7164 ) and physical activity diary in 40 volunteer men and women between 20 and 60 yr of age . RESULTS The correlation between the activity scale and the diary was high ( r = 0.74 , P = 0.000 ) , whereas correlation between the activity scale and accelerometer measurements was poor ( r = 0.20 , NS ) . The physical activity scale MET-time was systematic ally higher than average MET-time estimated from the diary , and the difference increased with increasing total MET-time . CONCLUSION The physical activity scale appears to be a simple and valid alternative to measuring physical activity by diary in adult sedentary to moderately active Danes . The scale encompasses work , leisure time , and sports activity in one measure ; it is easy to administer , and it provides detailed information on different activity levels as well as a single measure of the total amount of physical activity on an average weekday ABSTRACT Secondary stroke prevention is championed as guideline care ; yet there are no systematic programs offered . We developed a stroke self-management program to address this gap and pilot test the program . We conducted a r and omized controlled trial at two Veterans Administration ( VA ) hospital sites where we recruited patients with an acute stroke to receive either the stroke program or an attention-control protocol over a 12-week period following hospital discharge . The stroke program included six sessions that facilitated stroke self management focusing on increasing self-efficacy to recover from stroke and engage in secondary stroke risk factor management . We surveyed outcomes at baseline , 3 and 6 months . We conducted an intention to treat analysis comparing the intervention to the control group on changes of outcomes between baseline and follow-up modeled by a linear model with fixed effects for treatment , visit , and the treatment by visit interaction adjusting for baseline . We recruited 63 participants ( 33 control and 30 intervention ) who were hospitalized with a primary diagnosis of ischemic stroke . We found trends in differences between groups on self-efficacy to communicate with physicians , weekly minutes spent in aerobic exercise , and on dimensions of stroke-specific quality of life . This pilot study demonstrated the feasibility of delivering a  stroke self-management program to recent stroke survivors in a healthcare organization . The program also demonstrated improvements in patient self-efficacy , self-management behaviors , specific dimensions of stroke-specific quality of life compared to a group that received an attention placebo program UNLABELLED Mudge S , Barber PA , Stott NS . Circuit-based rehabilitation improves gait endurance but not usual walking activity in chronic stroke : a r and omized controlled trial . OBJECTIVE To determine whether circuit-based rehabilitation would increase the amount and rate that individuals with stroke walk in their usual environments . DESIGN Single-blind r and omized controlled trial . SETTING Rehabilitation clinic . PARTICIPANTS Sixty participants with a residual gait deficit at least 6 months after stroke originally enrolled in the study . Two withdrew in the initial phase , leaving 58 participants ( median age , 71.5y ; range , 39.0 - 89.0y ) who were r and omized to the 2 intervention groups . INTERVENTIONS The exercise group had 12 sessions of clinic-based rehabilitation delivered in a circuit class design ed to improve walking . The control group received a comparable duration of group social and educational classes . MAIN OUTCOME MEASURES Usual walking performance was assessed using the StepWatch Activity Monitor . Clinical tests were gait speed ( timed 10-meter walk ) and endurance ( six-minute walk test [ 6MWT ] ) , confidence ( Activities-Based Confidence Scale ) , self-reported mobility ( Rivermead Mobility Index [ RMI ] ) , and self-reported physical activity ( Physical Activity and Disability Scale ) . RESULTS Intention-to-treat analysis revealed that the exercise group showed a significantly greater distance for the 6MWT than the control group immediately after the intervention ( P=.030 ) but that this effect was not retained 3 months later . There were no changes in the StepWatch measures of usual walking performance for either group . The exercise and control groups had significantly different gait speed ( P=.038 ) and scores on the RMI ( P=.025 ) at the 3-month follow-up . These differences represented a greater decline in the control group compared with the exercise group for both outcome measures . CONCLUSIONS Circuit-based rehabilitation leads to improvements in gait endurance but does not change the amount or rate of walking performance in usual environments . Clinical gains made by the exercise group were lost 3 months later . Future studies should consider whether rehabilitation needs to occur in usual environments to improve walking performance Background and Purpose : Transient ischemic attack ( TIA ) is a strong predictor of stroke , and physical inactivity is one risk factor for TIA/stroke . “ Physical activity on Prescription ” ( PaP ) can increase physical activity , but the effect of PaP after TIA has not been described . Our goal was to objective ly measure the effect of PaP on physical activity and physical capacity , as well as self-rated health at 3 and 6 months after TIA . Methods : The primary outcome was moderate to vigorous intensities of physical activity objective ly assessed by accelerometry . Secondary outcomes were steps per day assessed by accelerometry , physical capacity assessed by the 6-minute walk test , and self-rated health assessed by EQ-5D VAS . Results : Eighty-eight individuals with TIA were r and omized to an intervention group ( n = 44 ) that received conventional treatment and PaP  or to a control group ( n = 44 ) that received conventional treatment alone . There was a 30 % dropout among the participants at 6 months . No significant differences between groups were found in physical activity at 3 and 6 months . At 6 months , participants in the intervention group were significantly more likely to have improved their physical capacity than the control group . There was no significant difference between groups in self-rated health . Discussion and Conclusions : PaP did not increase physical activity after TIA ; however , there was an increase in physical capacity . The nonsignificant results for physical activity may be the result of a relatively high baseline physical activity level . The results may also indicate that prior studies suggesting that PaP increases physical activity overestimated effects because of the self-reported nature of the previous outcomes . Video Abstract available for more insights from the authors ( see Supplemental Digital Content 1 , http://links.lww.com/JNPT/A134 ) OBJECTIVE To test the safety , feasibility , and effectiveness of reducing sitting time in stroke survivors . DESIGN R and omized controlled trial with attention-matched controls and blinded assessment s. SETTING Community . PARTICIPANTS Stroke survivors ( N=35 ; 22 men ; mean age , 66.9±12.7y ) . INTERVENTIONS Four counseling sessions over 7 weeks with a message of sit less and move more ( intervention group ) or calcium for bone health ( attention-matched control group ) . MAIN OUTCOME MEASURES Measures included safety ( adverse events , increases in pain , spasticity , or fatigue ) and feasibility ( adherence to trial protocol ) . Secondary measures included time spent sitting ( including in prolonged bouts ≥30min ) , st and ing , and stepping as measured by the thigh-worn inclinometer ( 7d , 24h/d protocol ) and time spent in physical activity of at least moderate intensity as measured by a triaxial accelerometer . The Multimedia Activity Recall for Children and Adults was used to describe changes in use of time . RESULTS Thirty-three participants completed the full protocol . Four participants reported falls during the intervention period with no other adverse events . From a baseline average of 640.7±99.6min/d  , daily sitting time  reduced on average by 30±50.6min/d ( 95 % confidence interval [ CI ] , 5.8 - 54.6 ) in the intervention group and 40.4±92.5min/d in the control group ( 95 % CI , 13.0 - 93.8 ) . Participants in both groups also reduced their time spent in prolonged sitting bouts ( ≥30min ) and increased time spent st and ing and stepping . CONCLUSIONS Our protocol was both safe and feasible . Participants in both groups spent less time sitting and more time st and ing and stepping postintervention , but outcomes were not superior for intervention participants . Attention matching is desirable in clinical trials and may have contributed to the positive outcomes for control participants Objective : To investigate whether early aerobic training has a beneficial effect on stroke patients '  independence in daily and social activities six months after the event . Design : R and omized clinical trial . Setting : Rehabilitation unit . Subjects : Ninety-two patients after a first stroke . Interventions : Forty-six patients participated in an eight-week programme of aerobic training , using a leg cycle ergometer . Main outcome measures : Frenchay Activities Index ( FAI ) measured twice , at entry to programme ( pre-event score ) and six months after the onset of the event . Results : Despite the significant improvement of study group patients ' functional abilities immediately after the intervention compared with controls , no significant difference was found in FAI mean score between groups six months post event . An interaction effect was noted between event severity , intervention and FAI total score . Mean FAI score declined significantly less in the less severely impaired study group patients . Conclusions : Early , moderately intense aerobic training has no direct impact on independence in daily and social activities as measured by FAI total score six months after a stroke This investigation compared ratings of perceived exertion specific to the active muscles used during resistance exercise ( RPE-AM ) using the 15-category Borg scale during high-intensity ( HIP ) and low-intensity ( LIP ) weight lifting . Ten men ( 23.2 ± 3.6 years ) and 10 women ( 21.8 ± 2.7 years ) performed 2 trials consisting of seven exercises : bench press ( BP ) , leg press , latissimus dorsi pull down , triceps press , biceps curl , shoulder press , and calf raise . The HIP and LIP protocol s were completed in counterbalanced order . During HIP , subjects completed 5 repetitions using 90 % of 1 repetition maximum ( 1RM ) . RPE-AM was measured after every repetition . During LIP , subjects completed 15 repetitions using 30 % of  1RM . RPE-AM was measured after every third repetition . RPE-AMs were greater ( p < 0.001 ) for HIP than for LIP for each exercise . For example , the mean initial BP RPE was 14.11 ± 2.08 for the HIP and 8.34 ± 1.35 for the LIP . Performing few repetitions using heavier weight is perceived to be more difficult than lifting comparatively lighter weight with more repetitions when external work is held constant Abstract Background : Many people with mild disability after stroke are physically inactive despite the risk of recurrent stroke . A self-management program may be one strategy to increase physical activity in stroke survivors . Objectives : To investigate the feasibility of a self-management program , and determine whether self-management can increase daily physical activity levels and self-efficacy for exercise , decrease cardiovascular risk , and improve walking ability , participation , and quality of life in people with mild disability after stroke . Method : A Phase I , single-group , pre-post intervention study was carried out with twenty stroke survivors who had mild disability and were discharged directly home from acute stroke units . A self-management program was delivered via five home-based sessions over 3 months , incorporating : education , goal setting , barrier identification , self-monitoring , and feedback .  Feasibility of the intervention was determined by examining adherence , duration , usefulness , and safety . Clinical outcomes were amount of physical activity ( duration of moderate physical activity in min/day and counts of physical activity in steps/day ) , self-efficacy , cardiovascular risk , walking ability , participation , and quality of life . Results : The intervention was feasible with 96 % of sessions being delivered , each taking less than an hour ( 41 min , SD 12 ) . Participants perceived the self-management program to be useful and there were few adverse events . At 3 months , participants completed 27 min/day ( 95 % CI 4–49 ) more moderate physical activity than at baseline and 16 min/day ( 95 % CI −10 to 42 ) at 6 months . Conclusion : Self-management appears to be feasible and has the potential to increase physical activity in people with mild disability after stroke . A Phase II r and omized trial is warranted
target: Face to face and telephone-based self-management programmes were identified as having promise to engage stroke survivors in PA behaviour change .
background: Background Increasing physical activity ( PA ) levels ( regular movement such as walking and activities of daily living ) and reducing time spent sedentary improves cardiovascular health and reduces morbidity and mortality .
  Fewer than 30 % of independently mobile stroke survivors undertake recommended levels of PA .
  Sedentary behaviour is also high in this population .
  We aim ed to systematic ally review the study characteristics and the promise of interventions targeting free-living PA and /or sedentary behaviour in adult stroke survivors .