Feasibility of Behavior Change Techniques to Promote Physical Activity of People With Acute Stroke During Hospitalization: A Pilot Randomized Controlled Trial

Abstract

Objective

To determine the feasibility of using behavior change techniques in people with acute stroke during hospitalization and to evaluate the preliminary effects of these interventions on the physical activity and mobility of the participants.

Design

Nonblinded, parallel-group pilot randomized controlled trial.

Setting

The trial was conducted in a stroke unit of a university hospital in Germany.

Participants

A random sample of 24 participants (N=24) was selected. Included were people with acute stroke (<48h after the incident), with National Institutes of Health Stroke Scale score 0-5, who were able to ambulate independently.

Interventions

Participants of the intervention group received 3 behavior change techniques alongside standard physiotherapy during their hospital stay: education, goal setting, and monitoring. In the control group, participants received standard physiotherapy.

Main Outcome Measures

Feasibility was assessed based on previously established feasibility criteria. Physical activity levels were measured using accelerometry, while mobility was evaluated with the de Morton Mobility Index.

Results

Twenty-four participants were recruited in total (participation rate: 77.4%), and 12 of them received the intervention. There were no drop-outs and none lost to follow-up (drop-out rate 0%; retention rate: 100%). The recruitment rate, retention, acceptability, and safety of the intervention were assessed as feasible. The target adherence of 80% potential wear time of an accelerometer could not be confirmed. No adverse events were reported. A trend for higher physical activity of the intervention group was observed; however, the results were not statistically significant.

Conclusions

Despite a small number of participants, the feasibility and safety of the use of behavior change techniques in people with acute stroke, as well as indications of a potential effect, were established. Therefore, after implementing adjustments regarding the recruitment and inclusion of participants, the recommendation can be made to conduct a definite trial.