Activating Behavior for Lasting Engagement After Stroke

Not Applicable

Completed

Conditions: Physical Activity
Behavior, Health
Physical Disability
Stroke
Sedentary Lifestyle

Brief Summary: Stroke survivors demonstrate high levels of sedentary behavior, placing them at risk for exacerbation of chronic health conditions. This may lead to recurrent stroke. Subtle cognitive impairments are common after stroke and can lead to difficulty self-monitoring and problem solving to overcome barriers to physical activity. Investigators developed the Activating Behavior for Lasting Engagement (ABLE) intervention to promote activity scheduling, self-monitoring, and problem solving activity over the full day. This study examines the effects of the ABLE intervention on sedentary behavior after stroke.

Detailed Description: The study advisory committee added a dose-matched, no-intervention delayed baseline to the study protocol following initial documentation of this study protocol on clinicaltrials.gov. The purpose of this delayed baseline design was to assess the baseline stability on the primary and secondary outcomes. The addition of this timepoint resulted in a shift of post-intervention timepoints as follows: Baseline 1 (week 1), Baseline 2 (week 6), Post-intervention (week 11), and Follow-up (week 18). Intervention was delivered between Baseline 2 and Post-intervention.

Recruitment & Eligibility

Inclusion Criteria

diagnosis of ischemic or hemorrhagic stroke
≥6 months and ≤24 months post-stroke
≥18 years of age
ambulatory in the community with or without an assistive device (e.g. walker, cane)
self-reported sedentary behavior (≥6 hours/day of sedentary behavior reported using the Sedentary Behavior Questionnaire)
reside within 50 miles of Pittsburgh, Pennsylvania

Exclusion Criteria

severe aphasia (Boston Diagnostic Aphasia Examination score ≤1)
currently receiving outpatient or home care rehabilitation services (physical therapy, occupational therapy, or speech therapy)
current active cancer treatment
medical history of neurodegenerative disorder (i.e. dementia, Parkinson's disease, multiple sclerosis, Lou Gehrig's disease (ALS), glioblastoma, myasthenia gravis)
current major depressive disorder, psychiatric condition, substance abuse (Patient Health Questionnaire-9, PRIME-MD/MINI)

Arm && Interventions

Group	Intervention	Description
Activating Behavior for Lasting Engagement	Activating Behavior for Lasting Engagement	Participants will engage in the ABLE intervention.

Primary Outcome Measures

Name	Time	Method
Change in Daily Number of Sedentary Breaks	Baseline (Baseline=computed mean of week 1 and week 6) to 11 weeks	Objectively measured sedentary breaks (ActivPAL)
Change in Daily Sedentary Time Accumulated in Bouts Greater Than or Equal to 30 Minutes	Baseline (Baseline=computed mean of week 1 and week 6) to 11 weeks	Objectively measured sedentary time (ActivPAL)

Secondary Outcome Measures

Name	Time	Method
Change in Daily Sedentary Time Accumulated in Bouts Greater Than or Equal to 30 Minutes	Baseline (Baseline=computed mean of week 1 and week 6) to 18 weeks	Objectively measured sedentary time (ActivPAL)
Change in Daily Number of Sedentary Breaks	Baseline (Baseline=computed mean of week 1 and week 6) to 18 weeks	Objectively measured sedentary breaks (ActivPAL)
Change in Participation	Baseline (Baseline=computed mean of week 1 and week 6) to 18 weeks	Client rated participation in meaningful daily life activities using the Stroke Impact Scale - Participation Subscale The Stroke Impact Scale - Participation Subscale is a questionnaire-based measure of community participation. Participants rate their participation in 10 types of activities on a 1 to 5 point Likert-type scale. Scores are converted to a 0 to 100 scale, where low scores indicate low participation.