Factors That Influence Compliance to Long-Term Remote Ischemic Conditioning Treatment in Patients With Ischemic Stroke

 

What will it take to get this written into a protocol and distributed worldwide?  If you want compliance tell survivors EXACTLY how many sessions of this will deliver recovery. Survivors will deliver the work needed with protocols NOT GUIDELINES.

You mean these earlier pieces of research were not enough to write up a protocol on this?

Leg wraps raise hopes of saved lives after strokes May 2013 

Leg compressions may enhance stroke recovery August 2012

Factors That Influence Compliance to Long-Term Remote Ischemic Conditioning Treatment in Patients With Ischemic Stroke

 

Jie Zhao^†, Kaiting Fan^†, Wenbo Zhao, Hui Yao, Jiayue Ma and Hong Chang^*

• Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disease, Beijing, China

Objectives: To investigate the treatment compliance of patients with ischemic stroke to remote ischemic conditioning (RIC) and to determine the factors that influence compliance.

Methods: We conducted a retrospective study of patients with ischemic stroke who were treated with RIC. Treatment compliance was determined and analyzed in patients who had received 1 year of RIC training. Factors that influenced patient compliance were also determined using univariate and multivariate regression analyses.

Results: Between March 2017 and February 2018, 91 patients were recruited into this study. The mean (±SD) age was 57.98 ± 10.76 years, and 78 (85.7%) patients were male. The baseline Kolcaba comfort scale of patients with good compliance scores were higher than those with poor compliance. The scores of the four dimensions in the scale and the total score are as follows: physiological dimensions, 15.0 (12.0,17.0) vs 17.0 (13.0,19.0); psychological dimensions, 30.0 (25.0,34.0) vs 31.0 (27.0,35.0); sociological dimensions, 20.0 (18.0,24.0) vs 21.0 (18.0,23.0); environmental dimensions, 19.0 (12.0,24.0) vs 20.0 (17.0,22.0); and total points, 82.0 (69.0,94.0) vs 91.0 (78.0,98.0). the differences between the groups were significant (p < 0.05), except for the sociological dimensions. A history of hypertension, number of follow-ups, and the physiological, psychological, and environmental dimensions of the comfort scale were related to patient compliance, out of which the number of follow-ups (Adjusted OR = 2.498, 95% confidence interval (CI) 1.257–4.964) and the physiological discomfort (Adjusted OR = 1.128, 95% CI 1.029–1.236) independently influenced compliance (p < 0.05).

Conclusion: In patients with ischemic cerebrovascular disease who were treated with RIC, the number of follow-up visits and physiological discomfort associated with RIC treatment independently influenced patient compliance. Further studies are needed to investigate the RIC protocols and their corresponding nursing models.

Introduction

Stroke is the second leading cause of death worldwide and the leading cause of death in countries such as China (1). Furthermore, ischemic stroke is the main subtype of stroke and accounts for 60–80% of all strokes (2). Treatment strategies for acute ischemic stroke (AIS) and its secondary prevention have been advanced significantly in the past decades; however, the prognosis of patients with AIS remains far from satisfactory. Therefore, effective adjuvant therapies for the treatment and secondary prevention of ischemic stroke are needed.

Remote ischemic conditioning (RIC), a non-invasive and easy-to-use method of physical therapy, which encompasses several cycles of ischemia/reperfusion training of an organ (e.g., limbs), confers protection to remote vital organs (3) and has been found to reduce recurrent strokes in patients with symptomatic intracranial artery atherosclerosis (4). It has also been found to improve cognitive function in patients with cerebral small vessel disease (5). Although its mechanism is not fully understood, studies have found that RIC could exert its protective effects immediately after the procedure, and this could last for 3–4 days with a 12-h unprotected interval (6). Therefore, RIC has been recommended for days or months, and previous clinical studies have reported protocols of RIC that range from once daily for 1 week to twice daily for 2 weeks, 6 months, and 1 year (7–9). For patients undergoing RIC for several months or years, compliance to RIC treatment is important to guarantee its protective effects. However, the compliance of patients with AIS to RIC treatment in real-world clinical practice and those factors that influence compliance remain unclear.

In this study, we aimed to investigate the compliance of patients with AIS who underwent repeated RIC for 1 year to RIC treatment and to determine the factors that influence compliance to RIC treatment.