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Approaches to promote reduction in sedentary behavior in patients with minor ischemic stroke: a randomized controlled trial [with consumer summary]
Ashizawa R, Honda H, Take K, Yoshizawa K, Ooba Y, Kameyama Y, Yoshimoto Y
Archives of Physical Medicine and Rehabilitation 2022 Feb;103(2):255-262
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The purpose of this study was to determine whether an approach that promotes reduction in sedentary behavior (SB), during hospitalization and after hospital discharge, reduces SB in patients with minor ischemic stroke (MIS) compared with an approach that promotes an increase in physical activity levels. DESIGN: Randomized controlled trial design. SETTING: During hospitalization and after hospital discharge PARTICIPANTS: We randomly assigned 61 patients with MIS (average age 71.3 +/- 8.3 years: men 65.6%) admitted to an acute hospital to either the intervention group (reduced SB group, n = 31) or the control group (increased physical activity levels group, n = 30). INTERVENTIONS: During hospitalization, the intervention group received: (1) education on reducing SB, (2) goal setting for SB after hospital discharge, and (3) self-monitoring of SB and the number of steps. In contrast, the control group received: (1) education on increasing physical activity levels and (2) self-monitoring of the number of steps. Patients in both groups wore an accelerometer during hospitalization till three months after hospital discharge. The intervention group received: (i) self-monitoring of SB and the number of steps, (ii) stickers including information about reducing their SB, and (iii) phone calls once every two weeks for encouragement and feedback. The control group only wore the accelerometer. MAIN OUTCOME MEASURES: The primary outcome was SB (%) at three months after hospital discharge. RESULTS: There was an interaction between the two groups for SB. Compared with the control group, the intervention group showed a significantly reduced SB (intervention group baseline 70.5%; three months after hospital discharge 48.6%; control group baseline 71.5%; three months after hospital discharge 57.5%; F value = 5.981; p = 0.018). CONCLUSIONS: The results suggest that an approach that promotes SB reduction during hospitalization and after hospital discharge is effective in reducing SB in patients with MIS three months after hospital discharge.

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