Platform Presentation The Joint Annual Meeting of the Stroke Society of Australasia (SSA) and Smartstrokes 2023

Lifestyle change to reduce stroke recurrence risk. Results of the telehealth-delivered ENAbLE Pilot Trial (#74)

Emily R Ramage 1 2 , Karly Zacharia 1 , Margaret Galloway 1 , Meredith Burke 1 , Elizabeth A Lynch 3 , Lesley MacDonald-Wicks 1 , Amanda Patterson 1 , Catherine M Said 2 4 , Coralie English 1
  1. School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia
  2. Western Health, St Albans, VIC, Australia
  3. Flinders University, Adelaide, SA, Australia
  4. University of Melbourne, Parkville, VIC, Australia

Background: A healthy lifestyle after stroke is critical to reducing stroke recurrence risk. Education alone is not sufficient to create this lifestyle change.   

Aim: To evaluate two co-designed telehealth-delivered lifestyle interventions (diet and physical activity) of 6-month duration for potential of effect and feasibility.

Methods: Randomised pilot trial with four arms (physical activity alone; diet alone; physical activity+diet; control). Participants were 3-months to 10-years post-stroke or TIA. Feasibility outcomes included measures of safety and attrition. Potential for effect was evaluated by systolic blood pressure (SBP), self-report physical activity (International Physical Activity Questionnaire) and diet quality (Australian Recommended Food Score). Between-group differences were analysed using linear mixed models.

Results: Forty participants were randomised (10 to each arm), 40% female, mean age 59 years, mean SBP 129.6mmHg at baseline. No serious adverse events were definitely related to the intervention.  Two people (20%) from the physical activity, one (10%) from the control and one (10%) from the combined intervention were lost to follow-up at 6-months.

Group differences in physical activity and SBP favoured participants undertaking the physical activity intervention when compared with those who did not at 3 and 6-months, but only reached statistical significance for physical activity levels at 3-months (estimated effect [95% confidence interval] 3-month 744(73 to 1415) METmin/wk and -4.1(-9.1 to 1.0) mmHg respectively,  at 6-month  550(-32 to 1421) METmin/wk and -0.9(-3.8 to1.9) mmHg respectively).

Diet quality was significantly better for those receiving the diet intervention compared to those who did not at 3 and 6-months (Australian Recommended Food Score 6.8[6.7 to 10.9] and 4.6[0.5 to 8.8] respectively). The improvements in SBP between groups favoured diet participants but did not reach significance -1.8(-6.8 to 3.3)mmHg and -2.3(-7.5 to 3.0)mmHg respectively.

Conclusion: Both telehealth-delivered lifestyle interventions show potential for effect and were feasible to implement as part of a 4-arm trial.