Pilot Trial Triumphs and Tribulations. A Feasibility Study of Supervised Exercise Delivered Via Telehealth for Secondary Stroke Prevention

ABSTRACT

Background and Aims: Medical management alone is insufficient to reduce secondary stroke risk. Supervised exercise combined with behaviour change support may facilitate increased physical activity and help adequately address stroke recurrence risk. This early analysis of the ENAbLE Pilot Trial aimed to test the feasibility of a supervised aerobic exercise package delivered via telehealth. Method(s) A 4-arm, assessor blinded RCT was piloted during the COVID-19 Pandemic. The remotely delivered trial included people 3 months to 10 years post stroke or TIA. The intervention involved 12 weeks of twice weekly telehealth-supervised aerobic exercise and support sessions. Feasibility data including recruitment, adherence, adverse events and ability to collect clinical outcomes to support a Phase III trial (blood pressure [primary outcome], physical activity, fatigue, and quality of life) was collected and analysed. Result(s) Thirty people participated (exercise intervention n=14, control n=16) between April 2020 and July 2021. Session attendance was 80%. Three participants (10%) withdrew or were lost to follow-up, all in the experimental group. Mean exercise intensity during supervised sessions was in the target range (moderate to vigorous). Mean number of systolic BP measures recorded over 7 days was 27 (SD 2.2) of a maximum of 28, at baseline. One non-serious adverse event occurred during supervised exercise sessions. However, outside exercise sessions adverse events were higher in the experimental group who were more frequently monitored. Conclusion(s) A remotely delivered program of supervised aerobic exercise delivered via telehealth was feasible. Learnings from the remote delivery of an exercise pilot trial will be shared. Acknowledgements Stroke Foundation Australia.