Rehabilitation Training After Stroke (ReTrain)
Stroke
About this trial
This is an interventional treatment trial for Stroke
Eligibility Criteria
Inclusion Criteria:
- Primary clinical diagnosis of stroke (assessed by referring clinician/GP records)
- >1 month (but no upper limit) since discharge from NHS physical rehabilitation services at randomisation
- Able to walk independently indoors with or without mobility aids, but has self-reported difficulty or requires help on stairs, slopes or uneven surfaces (assessed by recruiting team using standard tools)
- Willingness to be randomised to either control or ReTrain (and attend the training venue)
- Cognitive capacity and communication ability sufficient to participate in the study (assessed by recruiting team using standard tools).24 NB: Criterion (3) has been selected pragmatically to maximise eligibility while ensuring participants have a mobility deficit that could be addressed by the intervention. Eligible people with aphasia will not be excluded.
Exclusion Criteria:
- <18 years old
Contraindications to moderate to vigorous physical activity. Used in GP screening assessment form. (Adapted from ACSM guidelines 25) Contraindications include:
- Acute or uncontrolled heart failure
- Unstable or uncontrolled angina
- Uncontrolled cardiac dysrhythmia causing symptoms or haemodynamic compromise
- Symptomatic severe aortic stenosis
- Current deep vein thrombosis, pulmonary embolus or pulmonary infarction
- Acute myocarditis or pericarditis
- Suspected or known dissecting aneurysm
- Unstable / uncontrolled blood pressure
- Systolic blood pressure > 160
- Diastolic blood pressure > 100
- Acute systemic infection
- Uncontrolled diabetes
Sites / Locations
- University of Exeter Medical School
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Rehabilitation training
Control
ReTrain: an exercise-based functional training programme comprising two phases: (1) weekly supervised sessions; (2) monthly drop-in sessions, plus home-based exercise in each phase. Week 1: one-to-one consultations with trainer to introduce programme, assess individual's concerns and capabilities, introduce and negotiate initial goals Weeks 2-11: bi-weekly 90 minute group class with group-based activities and one-to-one coaching, based on ongoing goal negotiation review and progression. Week 12: one-to-one consultations with trainer to review goals and plan ongoing unsupervised exercise programme Weeks 13-24: monthly drop-in sessions for one-to-one consultation, support and progression.
Control: treatment as usual plus receipt of a UK Stroke Association booklet on exercise after stroke.