Background: Insufficient amounts of physical activity is a risk factor for (recurrent) stroke. People with a stroke or
transient ischemic attack (TIA) have a high risk of recurrent stroke and have lower levels of physical activity than
their healthy peers. Though several reviews have looked at the effects of lifestyle interventions on a number of risk
factors of recurrent stroke, the effectiveness of these interventions to increase the amounts of physical activity
performed by people with stroke or TIA are still unclear. Therefore, the research question of this study was: what is
the effect of lifestyle interventions on the level of physical activity performed by people with stroke or TIA?
Method: A systematic review was conducted following the guidelines of the Preferred Reporting Items for
Systematic Reviews and Meta-analyses (PRISMA) statement. Pubmed, Embase and Cumulative Index for Nursing and
Allied Health Literature (CINAHL), were searched up to August 2018. Randomised controlled trials that compared
lifestyle interventions, aimed to increase the amount of physical activity completed by participants with a stroke or
TIA, with controls were included. The Physiotherapy Evidence Database (PEDro) score was used to assess the quality
of the articles, and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method
for the best evidence synthesis.
Results: Eleven trials (n = 2403) met the inclusion criteria. The quality of the trials was mostly high, with 8 (73%) of
trials scoring ≥6 on the PEDro scale. The overall best evidence syntheses showed moderate quality evidence that
lifestyle interventions do not lead to significant improvements in the physical activity level of people with stroke or
TIA. There is low quality evidence that lifestyle interventions that specifically target physical activity are effective at
improving the levels of physical activity of people with stroke or TIA.
Conclusion: Based on the results of this review, general lifestyle interventions on their own seem insufficient in
improving physical activity levels after stroke or TIA. Lifestyle interventions that specifically encourage increasing
physical activity may be more effective. Further properly powered trials using objective physical activity measures
are needed to determine the effectiveness of such interventions.
