Increasing time spent engaging in moderate-to-vigorous physical activity by community-dwelling adults following a transient ischemic attack or non-disabling stroke: a systematic review

Purpose:The risk of recurrent stroke following a transient ischaemic attack (TIA) or non-disabling stroke is high. Clinical guidelines recommend this patient population accumulate at least 150 minutes of moderate-to-vigorous physical activity each week to reduce the risk of recurrent stroke. We aimed to identify interventions that increase time adults spend in moderate-to-vigorous physical activity following TIA or non-disabling stroke. Method:We searched thirteen databases for articles of secondary prevention interventions reporting outcomes for duration in moderate-to-vigorous physical activity or exercise capacity. Results:Eight trials were identified (n = 2653). Of these, three (n = 198) reported changes in time spent in moderate-to-vigorous physical activity. Only one trial (n = 70), reported significant change in time spent engaging in moderate-to-vigorous physical activity (between-group difference: 11.7 min/day [95% CI 4.07-19.33]) when comparing participation in a six-month exercise education intervention to usual care. No trial measured moderate-to-vigorous physical activity after intervention end. Conclusion:Despite recommendations to participate in regular physical activity at moderate-to-vigorous intensity for secondary stroke prevention, there is very little evidence for effective interventions for this patient population. There is need for clinically feasible interventions that result in long-term participation in physical activity in line with clinical guidelines.

Automated summary

The purpose of this study was to identify interventions that increase time spent in moderate-to-vigorous physical activity in patients with TIA or non-disabling stroke. However, there is currently very limited evidence for effective interventions for this patient population, highlighting the need for more clinically feasible interventions.