Motivators for physical activity in patients with minor stroke: a qualitative study.

PURPOSE: Physical inactivity is a major risk factor for stroke. However, to encourage physical activity after stroke, it is important to know what motivates the patients. We aimed to explore possible motivators and barriers for physical activity in patients discharged after minor stroke or transient ischemic attack (TIA). METHODS: A qualitative study including 35 patients (21 men) with minor stroke or TIA (median age; 69 years, range 47-90) in semi-structured focus group interviews. Audio recordings were transcribed to text verbatim and analyzed with qualitative content analysis. RESULTS: Six interviews of 60 min. revealed five categories; the patients had a positive attitude towards physical activity, and they preferred to exercise locally under supervision of health professionals. Physical activity with others was motivating and obligating, and if possible as a weekly habit. Some experienced physical- and mental sequelae, which kept them from exercising. CONCLUSION: This study provides valuable knowledge of what motivates and prevents patients with minor stroke or TIA to be physically active after hospital discharge, and what to consider when designing future exercise studies. Consequently, it is recommended that patients with minor stroke or TIA are offered supervised physical activity to prevent worsening of cardiovascular disease and recurrent cardiovascular event.Implications for rehabilitationParticipants were positive towards physical activity after minor stroke or transient ischemic attack (TIA).Physical activity with others was perceived as both motivating and obligating.Post-stroke fatigue, lack of energy, and overview should be considered when designing secondary prevention programs.Participants call for exercise opportunities arranged locally and as group exercise supervised by health professionals with knowledge of stroke.

Translational challenges of remote ischemic conditioning in ischemic stroke - a systematic review.

Remote ischemic conditioning (RIC) has well-established cardioprotective effects in preclinical studies and promising results in preclinical stroke research. Effective translation from preclinical studies to clinical trials has yet to be accomplished, perhaps because of the use of multiple applications of RIC (e.g., pre-, per-, or post-conditioning) in preclinical studies by both invasive and non-invasive protocols, some of which not clinically applicable. Our systematic review conformed to PRISMA guidelines and addressed differences in clinically relevant RIC applications and outcomes between preclinical and clinical studies. We retrieved a total of 30 studies (8 human; 22 animal) that met the inclusion criteria of testing clinically relevant procedures; namely, non-invasive and per- or post-conditioning protocols. Per-conditioning was applied in 6 animal and 3 human studies, post-conditioning was applied in 16 animal and 5 human studies, and both conditioning methods were applied in 2 animal studies. Application of RIC varied between human and animal studies regarding initiation, duration, repetition, and number of limbs included. Study designs did not systematically apply blinding, randomization, or placebo controls. On only a few occasions did preclinical studies include animals with clinically relevant comorbidities. Clinical trials were challenged by not completing the intended number of RIC cycles or addressing this deficit in the data analysis. Consistency and transferability of methods used for positive animal studies and subsequent human studies are essential for the optimal translation of results. Consensus on preclinical and clinical RIC procedures should be reached for a full understanding of the possible beneficial effects of RIC treatment in stroke.