Participants' Perspective of Engaging in a Gym-Based Health Service Delivered Secondary Stroke Prevention Program after TIA or Mild Stroke.

Maria Sammut,Gary Crowfoot,Heidi Janssen,Michael Nilsson,Kirsti Haracz,David Shakespeare,Coralie English

doi:10.3390/ijerph182111448

Abstract

People who have had a transient ischemic attack (TIA) or mild stroke have a high risk of recurrent stroke. Secondary prevention programs providing support for meeting physical activity recommendations may reduce this risk. Most evidence for the feasibility and effectiveness of secondary stroke prevention arises from programs developed and tested in research institute settings with limited evidence for the acceptability of programs in ‘real world’ community settings. This qualitative descriptive study explored perceptions of participation in a secondary stroke prevention program (delivered by a community-based multidisciplinary health service team within a community gym) by adults with TIA or mild stroke. Data gathered via phone-based semi-structured interviews midway through the program, and at the end of the program, were analyzed using constructivist grounded theory methods. A total of 51 interviews from 30 participants produced two concepts. The first concept, “What it offered me”, describes critical elements that shape participants’ experience of the program. The second concept, “What I got out of it” describes perceived benefits of program participation. Participants perceived that experiences with peers in a health professional-led group program, held within a community-based gym, supported their goal of changing behaviour. Including these elements during the development of health service strategies to reduce recurrent stroke risk may strengthen program acceptability and subsequent effectiveness.

Highlights

IntroductionA transient ischemic attack (TIA) is a focal and rapid neurological disturbance resulting from a temporary disruption of arterial blood flow with no residual brain tissue death (infarction) and complete resolution of symptoms [1,2]
This study aimed to explore the perceptions and experiences of people with transient ischemic attack (TIA) or mild stroke who participated in a secondary stroke prevention program delivered by a health service in a community-based gym setting
Evidence in preparation by the authors suggests that most people who have experienced TIA and mild stroke make no change to their physical activity behaviour post-stroke event, irrespective of previous levels of physical activity [33], adding gravity to the importance of delivering secondary stroke prevention programs that have strong client acceptability

Summary

Introduction

A transient ischemic attack (TIA) is a focal and rapid neurological disturbance resulting from a temporary disruption of arterial blood flow with no residual brain tissue death (infarction) and complete resolution of symptoms [1,2]. While persistent disruption of blood flow results in brain tissue infarction and subsequent stroke, people with mild stroke generally experience rapidly resolving symptoms and are assessed as having minimal to no residual physical deficits [3,4]. There is an assumption that individuals return to pre-stroke event activity levels following a TIA or mild stroke and require little to no referral to follow.

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Conclusion