Effects on walking performance and lower body strength by short message service guided training after stroke or transient ischemic attack (The STROKEWALK Study): a randomized controlled trial

• Published in: Clinical rehabilitation Vol. 35; no. 2; pp. 276 - 287
• Main Authors: Vahlberg, Birgit, Lundström, Erik, Eriksson, Staffan, Holmbäck, Ulf, Cederholm, Tommy
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.02.2021
• Subjects: Exercise; Exercise Therapy; Female; Humans; Ischemic Attack, Transient - physiopathology; Ischemic Attack, Transient - psychology; Ischemic Attack, Transient - rehabilitation; Male; Middle Aged; Muscle Strength - physiology; Stroke - physiopathology; Stroke - psychology; Stroke - therapy; Stroke Rehabilitation - methods; Text Messaging; Walking - physiology; Walking - psychology; Stroke; secondary prevention; TIA; rehabilitation interventions; physical activity
• ISSN: 0269-2155; 1477-0873
• DOI: 10.1177/0269215520954346

Objective: To evaluate whetherdaily mobile-phone delivered messages with training instructions during three months increase physical activity and overall mobility in patients soon after stroke or transient ischemic attack. Design: Randomised controlled trial with intention-to-treat analyses. Setting: University hospital. Data collection from November 2016 until December2018. Subjects: Seventy-nine patients (mean (SD) age 63.9 (10.4) years, 29 were women) were allocated to either intervention (n = 40) or control group (n = 39). Participants had to be independent (modified Ranking Scale ⩽2) and able to perform the six-minute walking test at discharge from the hospital. Interventions: The intervention group received standard care and daily mobile phone instructional text messages to perform regular outdoor walking and functional leg exercises. The control group received standard care; that is, primary care follow-up. Main measures: Walking performance by six-minute walking test (m), lower body strength by five times chair-stand test (s), the short physical performance battery (0–12 points) and 10-metres walk test (m/s) were assessed at baseline and after three months. Results: The estimated median difference in the six-minute walking test was in favour of the intervention group by 30 metres (95% CI, 55 to 1; effect size 0.64; P = 0.037) and in the chair-stand test by 0.88 seconds (95% CI, 0.02 to 1.72; effect size 0.64; P = 0.034). There were no differences between groups on the short physical performance battery or in 10-metres walking time. Conclusions: Three months of daily mobile phone text messages with guided training instructions improved composite mobility measures; that is, walking performanceand lower body strength. Clinical Trial Registry: The study is registered with ClinicalTrials.gov, number NCT02902367.