Effect of individualized coaching at home on walking capacity in subacute stroke patients: A randomized controlled trial (Ticaa’dom)

“Lessons Learned” Preventing Recurrent Ischemic Strokes through Secondary Prevention Programs: A Systematic Review

“…Our study showed that interventions focusing on ensuring medications were prescribed, adhered to, and given at effective doses [ 14 , 18 ] seemed to be more successful than those that did not focus on medications [ 25 , 27 , 28 , 34 , 35 , 36 , 37 , 38 ]. However, some successful programs did not focus on medication [ 15 , 32 , 41 , 45 ] and some unsuccessful programs did [ 6 , 26 , 56 ].…”

“…Most programs that focused on education or education plus physical activity were not effective (SEP, ICMP, Education and Support Package, High-Intensive Exercise Program, Denny et al) [ 32 , 33 , 34 , 35 , 36 ]. Additionally, programs that focused solely on physical activity were mostly not effective (Ticaa’dom, ExStroke, LAST) [ 37 , 38 , 39 ]. Figure 1 and Supplementary Table S1 include further detailed information about the included studies, strategies, and outcomes.…”

“…Live/in-person strategies were effective in a number of instances (11 out of 25; Comprehensive Reminder System, PROTECT, SRP, Masterstroke, NAILED, Aerobic Rehab, PINGS, DESERVE, SMART, INSPiRE-TMS, SPS3) [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 40 , 41 , 42 ]; however, many of the studies were not (14 out of 25; SEP, PRAISE, LAST, ExStroke, Ticaa’dom, High-Intensive Exercise Program, PREVENT, STARS Plus, Education and Support Package, BRIDGE Stroke, Outreach Nursing and Motivational Interviewing, Adie et al and Feldman, et al) [ 6 , 22 , 23 , 24 , 25 , 27 , 28 , 30 , 33 , 35 , 36 , 37 , 38 , 39 ]. Studies that utilized a virtual component of delivery were effective in three cases (SMART, DESERVE, Kim et al) and not effective in five cases (ICMP, THRIVES, Point of Care EHR Prompt, Ticaa’dom, Denny et al) [ 16 , 17 , 25 , 30 , 33 , 36 , 42 , 43 ].…”

“…The PRAISE trial intervention group trended towards a slightly larger magnitude of BP reduction; however, this was also not statistically different from the control group [ 30 , 38 ]. Ticaa’dom observed an increased walking distance in the 6MWT in the intervention and control group from baseline at both 6 and 12 months; however, the intervention group did not perform better than controls [ 37 ]. Adie et al reported improved medication knowledge after the intervention, but no difference in systolic BP, total cholesterol, or medication adherence [ 22 ].…”

“…Aerobic Rehab was able to demonstrate significant differences in 6MWT and Met-minutes, despite 78% of the control group engaging in non-supervised exercise, suggesting that supervised exercise is superior, even in the face of improved health behaviors of the controls [ 42 ]. However, one must keep in mind that other initiatives with in-person exercise components were not nearly as successful, including LAST [ 39 ], ExStroke [ 38 ], Ticaa’dom [ 37 ] and the High-Intensive Exercise Program [ 36 , 37 , 38 , 39 ]. Keeping the supervised exercise regime close to a cardiac rehab may maximize the value of the intervention.…”