Home-based self-management for physically inactive individuals with mild walking disability after stroke: a randomised pilot study.

Abstract

To investigate the potential of a home-based self-management program to promote physical activity more than usual care at 3 and 6 months. A Phase II pilot randomised trial with concealed allocation, blinded measurement, and intention-to-treat analyses. Twenty-four individuals who were physically inactive, had a stroke within the past six months, and had mild walking disability were recruited. The experimental group received six 60-minute sessions of home-based self-management and usual care over 3 months. The control group received one 60-minute educational session on stroke and usual care. Primary outcome was physical activity (steps/day) at baseline, 3 and 6 months. Secondary outcomes were cardiovascular risk, walking ability, depression, exercise self-efficacy, participation, and quality of life. No statistically significant difference between-group was found at 3 and 6 months. At 3 months, clinically meaningful between-group differences were found for physical activity (MD 1380 steps/day), self-efficacy (MD 2 points), and participation (MD 13%). At 6 months, clinically meaningful between-group differences were found in self-efficacy (MD 3 points) and participation (MD 11%). The lack of sustained improvement in physical activity suggests further studies should focus on enhancing self-efficacy and maintaining engagement in self-monitoring. Clinical Trials NCT05461976.