TY - JOUR

T1 - Effect and efficacy of lifestyle interventions as secondary prevention

AU - Liljehult, Jacob

AU - Christensen, Thomas

AU - Molsted, Stig

AU - Overgaard, Dorthe

AU - Mesot Liljehult, Monique

AU - Møller, Tom

PY - 2020

Y1 - 2020

N2 - Introduction Improvements in health behaviour are often recommended as part of secondary prevention in patients with stroke and transient ischaemic attack. However, there is a lack of knowledge as to how this is applied in clinical practice. Aim In this systematic review and meta-analysis, we examined the effect of counselling or educational intervention directed at individual or multiple behavioural risk factors on blood pressure and other reported outcomes. Methods PubMed, Embase, PsycInfo, CINAHL, Scopus and Web of Science were systematically searched. Meta-analyses were conducted on all outcome measures if appropriate. A qualitative analysis of the content of the interventions was conducted to review which elements the interventions consisted of. Results Twenty-nine randomized controlled trials were identified. Fourteen reported effects on systolic blood pressure, and pooled results showed a significant beneficial effect (n = 2,222; -3.85 mmHg [95%CI -6.43; -1.28]). The effect was greatest in the four interventions which included supervised training (n = 174; -9.83 mmHg [95%CI -16.56; -3.09]). Conclusion Modifying health behaviour in stroke survivors might have a moderate beneficial effect on blood pressure, especially if the intervention includes supervised physical training.

AB - Introduction Improvements in health behaviour are often recommended as part of secondary prevention in patients with stroke and transient ischaemic attack. However, there is a lack of knowledge as to how this is applied in clinical practice. Aim In this systematic review and meta-analysis, we examined the effect of counselling or educational intervention directed at individual or multiple behavioural risk factors on blood pressure and other reported outcomes. Methods PubMed, Embase, PsycInfo, CINAHL, Scopus and Web of Science were systematically searched. Meta-analyses were conducted on all outcome measures if appropriate. A qualitative analysis of the content of the interventions was conducted to review which elements the interventions consisted of. Results Twenty-nine randomized controlled trials were identified. Fourteen reported effects on systolic blood pressure, and pooled results showed a significant beneficial effect (n = 2,222; -3.85 mmHg [95%CI -6.43; -1.28]). The effect was greatest in the four interventions which included supervised training (n = 174; -9.83 mmHg [95%CI -16.56; -3.09]). Conclusion Modifying health behaviour in stroke survivors might have a moderate beneficial effect on blood pressure, especially if the intervention includes supervised physical training.

KW - adherence

KW - exercise

KW - health behaviour

KW - health counselling

KW - physical activity

KW - smoking

KW - stroke

KW - transient ischaemic attack

KW - TRANSIENT ISCHEMIC ATTACK

KW - TELEPHONE FOLLOW-UP

KW - RISK-FACTORS

KW - MINOR STROKE

KW - MANAGEMENT

KW - CARE

KW - POSTSTROKE

KW - PROGRAM

KW - MODEL

KW - TRIAL

U2 - 10.1111/ane.13308

DO - 10.1111/ane.13308

M3 - Review

C2 - 32620044

VL - 142

SP - 299

EP - 313

JO - Acta Neurologica Scandinavica, Supplement

JF - Acta Neurologica Scandinavica, Supplement

SN - 0065-1427

IS - 4

ER -