Potential effects on cardiometabolic risk factors and body composition by short message service (SMS)-guided training after recent minor stroke or transient ischaemic attack: post hoc analyses of the STROKEWALK randomised controlled trial.
Study Goal
The researchers aimed to evaluate the effects of mobile phone text-messaging exercise instructions (focused on walking and functional leg exercises) on body composition, cardiometabolic risk markers, and self-reported health in stroke patients at 3 months post-intervention.
Results Summary
Both intervention and control groups showed favorable changes in fat-free mass and fat mass, as well as improvements in cholesterol-related biomarkers, but no significant between-group differences were observed. Self-reported health was high in both groups (94% and 86% reporting very good/fairly good health, respectively).
Population
79 stroke patients (mean age 64, 37% female) with good motor function (modified Rankin Scale ≤2) and capable of performing a 6-minute walking test at hospital discharge.
Effective Dosage
Daily mobile phone instructional text messages to perform regular outdoor walking and functional leg exercises.
Duration
3 months
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
daily mobile phone instructional text messages to perform regular outdoor walking and functional leg exercises | increase | fat-free mass | patients with good motor function after stroke | 1.83 kg | changed favourably | #1 |
daily mobile phone instructional text messages to perform regular outdoor walking and functional leg exercises | decrease | fat mass | patients with good motor function after stroke | -1.30 kg | changed favourably | #2 |
daily mobile phone instructional text messages to perform regular outdoor walking and functional leg exercises | decrease | total cholesterol | patients with good motor function after stroke | -0.65 mmol/L | improved | #3 |
daily mobile phone instructional text messages to perform regular outdoor walking and functional leg exercises | increase | self-perceived health | patients with good motor function after stroke | 94% | reported very good/fairly good health | #4 |
standard care | increase | fat-free mass | patients with good motor function after stroke | 1.22 kg | changed favourably | #5 |
standard care | decrease | fat mass | patients with good motor function after stroke | -0.76 kg | changed favourably | #6 |
standard care | decrease | total cholesterol | patients with good motor function after stroke | -1.1 mmol/L | improved | #7 |
standard care | increase | self-perceived health | patients with good motor function after stroke | 86% | reported very good/fairly good health | #8 |
3 months daily mobile phone delivered training instructions | no change | body composition | patients after recent stroke | - | no clear effect | #9 |
3 months daily mobile phone delivered training instructions | no change | cardiovascular biochemical risk factors | patients after recent stroke | - | no clear effect | #10 |
3 months daily mobile phone delivered training instructions | no change | self-perceived health | patients after recent stroke | - | no clear effect | #11 |
OBJECTIVES: To evaluate effects of mobile phone text-messaging exercise instructions on body composition, cardiometabolic risk markers and self-reported health at 3 months after stroke. DESIGN: Randomised controlled intervention study with per-protocol analyses. SETTING: University Hospital in Sweden. PARTICIPANTS: Seventy-nine patients (mean (SD) age 64 (10) years, 37% female) ≥18 years with good motor function (modified Rankin Scale ≤2) and capable to perform 6 min walking test at hospital discharge were randomised to either intervention (n=40) or control group (n=39). Key exclusion criteria: subarachnoid bleeding, uncontrolled hypertension, severe psychiatric problems or cognitive limitations. INTERVENTIONS: The intervention group received beyond standard care, daily mobile phone instructional text messages to perform regular outdoor walking and functional leg exercises. The control group received standard care. MAIN OUTCOME MEASURES: Fat mass and fat-free mass were estimated by bioelectric impedance analysis. Cardiometabolic risk factors like blood lipids, glycated haemoglobin and blood glucose were analysed at baseline and after 3 months. RESULTS: Both groups changed favourably in fat-free mass (1.83 kg, 95% CI 0.77 to 2.89; p=0.01, effect size (ES)=0.63 vs 1.22 kg, 95% CI 0.39 to 2.0; p=0.05, ES=0.54) and fat mass (-1.30 kg, 95% CI -2.45 to -0.14; p=0.029, ES=0.41 vs -0.76 kg, 95% CI -1.74 to 0.22; p=0.123, ES=0.28). Also, many cholesterol related biomarkers improved; for example, total cholesterol -0.65 mmol/L, 95% CI -1.10 to -0.2; p=0.06, ES: 0.5 vs -1.1 mmol/L, 95% CI -1.47 to -0.56; p>0.001, ES=0.8. However, there were no between-group differences. At 3 months, 94% and 86%, respectively, reported very good/fairly good health in the text messaging and control groups. CONCLUSIONS: No clear effect of 3 months daily mobile phone delivered training instructions was detected on body composition, cardiovascular biochemical risk factors or self-perceived health. Further research is needed to evaluate secondary prevention efforts in larger populations after recent stroke. TRIAL REGISTRATION NUMBER: NCT02902367.