Deans' stroke musings: EXPRESS: Telehealth coaching to improve self-management for secondary prevention after stroke: A randomized controlled trial of Stroke Coach

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, May 6, 2021

EXPRESS: Telehealth coaching to improve self-management for secondary prevention after stroke: A randomized controlled trial of Stroke Coach

Wrong focus. You need coaching for your doctors and hospitals to create EXACT STROKE PREVENTION PROTOCOLS. Guidelines don't count.

EXPRESS: Telehealth coaching to improve self-management for secondary prevention after stroke: A randomized controlled trial of Stroke Coach

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Brodie M Sakakibara

, Scott A Lear, Susan I Barr, , , , , , , ...

First Published May 5, 2021 Research Article

Abstract

Background:

Stroke Coach is a lifestyle coaching telehealth program to improve self-management of stroke risk factors.

Aims:

To examine the efficacy of Stroke Coach on lifestyle behaviour and risk factor control among community-living stroke survivors within one-year post stroke.

Methods:

Participants were randomized to Stroke Coach or an attention control Memory Training group. Lifestyle behaviour was measured using the Health Promoting Lifestyle Profile II. Secondary outcomes included specific behavioural and cardiometabolic risk factors, health-related quality of life (HRQoL), cognitive status, and depressive symptoms. Measurements were taken at baseline, post-intervention (6 months), and retention (12 month). Linear mixed-effects models were used to test the study hypotheses (p<0.05). All analyses were intention-to-treat.

Results:

The mean age of the Stroke Coach (n=64) and Memory Training (n=62) groups was 67.2 and 69.1 years, respectively. The majority of participants (n = 100) had mild stroke (modified Rankin Scale = 1 or 2), were active, with controlled blood pressure (mean = 129/79 mmHg) at baseline. At post-intervention, there were no significant differences in lifestyle (b = -2.87; 95%CI -8.03 to 2.29; p=0.28). Glucose control, as measured by HbA1c (b = 0.17; 95%CI 0.17 to 0.32; p=0.03), and HRQoL, measured using SF-36 Physical Component Summary (b = -3.05; 95%CI -5.88 to -0.21; p=0.04), were significantly improved in Stroke Coach compared to Memory Training, and the improvements were maintained at retention.

Conclusion:

Stroke Coach did not improve lifestyle behaviour(Because you were giving them guidelines not exact protocols.), however, there were improvements to HbA1c and HRQoL among community-living stroke survivors with mild stroke-related disability. (ClinicalTrials.gov identifier: NCT02207023)

Keywords Chronic disease, Clinical trial, Intervention, Prevention, Rehabilitation, Risk factors, Stroke, Telemedicine