Stroke Prevention Rehabilitation Intervention Trial of Exercise (SPRITE) - a randomised feasibility study

BMC Cardiovasc Disord. 2017 Dec 12;17(1):290. doi: 10.1186/s12872-017-0717-9.


Background: The value of cardiac rehabilitation (CR) after a transient ischaemic attack (TIA) or minor stroke is untested despite these conditions sharing similar pathology and risk factors to coronary heart disease. We aimed to evaluate the feasibility of conducting a trial of an adapted home-based CR programme, 'The Healthy Brain Rehabilitation Manual', for patients following a TIA/minor stroke, participants' views on the intervention and, to identify the behaviour change techniques (BCTs) used.

Methods: Clinicians were asked to identify patients attending the Ulster Hospital, Belfast within 4 weeks of a first TIA or minor stroke. Those who agreed to participate underwent assessments of physical fitness, cardiovascular risk, quality of life and mental health, before random allocation to: Group (1) standard/usual care; (2) rehabilitation manual or (3) manual plus pedometer. All participants received telephone support at 1 and 4 weeks, reassessment at 6 weeks and an invitation to a focus group exploring views regarding the study. Two trained review authors independently assessed the manual to identify the BCTs used.

Results: Twenty-eight patients were invited to participate, with 15 (10 men, 5 women; 9 TIA, 6 minor stroke; mean age 69 years) consenting and completing the study. Mean time to enrolment from the TIA/stroke was 20.5 days. Participants completed all assessment measures except VO2max testing, which all declined. The manual and telephone contact were viewed positively, as credible sources of advice. Pedometers were valued highly, particularly for goal-setting. Overall, 36 individual BCTs were used, the commonest being centred around setting goals and planning as well as social support.

Conclusion: Recruitment and retention rates suggest that a trial to evaluate the effectiveness of a novel home-based CR programme, implemented within 4 weeks of a first TIA/minor stroke is feasible. The commonest BCTs used within the manual revolve around goals, planning and social support, in keeping with UK national guidelines. The findings from this feasibility work have been used to further refine the next stage of the intervention's development, a pilot study.

Trial registration: Identifier: NCT02712385 . This study was registered prospectively on 18/03/2016.

Keywords: Cardiac rehabilitation; Minor stroke; SPRITE; Secondary cardiovascular prevention; TIA; ‘The Healthy Brain Rehabilitation Manual’; ‘The Heart Manual’.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Actigraphy / instrumentation
  • Aged
  • Exercise Therapy / instrumentation
  • Exercise Therapy / methods*
  • Feasibility Studies
  • Female
  • Fitness Trackers
  • Health Knowledge, Attitudes, Practice
  • Home Care Services, Hospital-Based*
  • Humans
  • Ischemic Attack, Transient / diagnosis
  • Ischemic Attack, Transient / physiopathology
  • Ischemic Attack, Transient / psychology
  • Ischemic Attack, Transient / rehabilitation*
  • Male
  • Manuals as Topic
  • Middle Aged
  • Motivation
  • Northern Ireland
  • Patient Compliance
  • Patient Education as Topic
  • Protective Factors
  • Recovery of Function
  • Recurrence
  • Risk Factors
  • Secondary Prevention / instrumentation
  • Secondary Prevention / methods*
  • Social Support
  • Stroke / diagnosis
  • Stroke / physiopathology
  • Stroke / psychology
  • Stroke / therapy*
  • Stroke Rehabilitation / instrumentation
  • Stroke Rehabilitation / methods*
  • Time Factors
  • Treatment Outcome

Associated data