Secondary prevention of stroke. A telehealth-delivered physical activity and diet pilot randomized trial (ENAbLE-pilot)

Coralie English, Emily R. Ramage, John Attia, Julie Bernhardt, Billie Bonevski, Meredith Burke, Margaret Galloway, Graeme J. Hankey, Heidi Janssen, Richard Lindley, Elizabeth Lynch, Chris Oldmeadow, Catherine M. Said, Neil J. Spratt, Karly Zacharia, Lesley MacDonald-Wicks, Amanda Patterson

Research output: Contribution to journalArticlepeer-review

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Background: Improving physical activity levels and diet quality are important for secondary stroke prevention. 

Aim: To test the feasibility and safety of 6-month, co-designed telehealth-delivered interventions to increase physical activity and improve diet quality. 

Methods: A 2 × 2 factorial trial (physical activity (PA); diet (DIET); PA + DIET; control) randomized, open-label, blinded endpoint trial. Primary outcomes were feasibility and safety. Secondary outcomes included stroke risk factors (blood pressure, self-report PA (International Physical Activity Questionnaire (IPAQ)) and diet quality (Australian Recommended Food Score (ARFS)), and quality of life. Between-group differences were analyzed using linear-mixed models. 

Results: Over 23 months, 99 people were screened for participation and 40 (40%) randomized (3 months to 10 years post-stroke, mean age 59 (16) years). Six participants withdrew, and an additional five were lost to follow-up. Fifteen serious adverse events were reported, but none were deemed definitely or probably related to the intervention. Median attendance was 32 (of 36) PA sessions and 9 (of 10) DIET sessions. The proportion of missing primary outcome data (blood pressure) was 3% at 3 months, 11% at 6 months, and 14% at 12 months. Between-group 95% confidence intervals showed promising, clinically relevant differences in support of the interventions across the range of PA, diet quality, and blood pressure outcomes. 

Conclusion: Our telehealth PA and diet interventions were safe and feasible and may have led to significant behavior change. 

Trial Registration: ACTRN12620000189921.

Original languageEnglish
Pages (from-to)199-208
Number of pages10
JournalInternational Journal of Stroke
Issue number2
Early online date2 Sept 2023
Publication statusPublished - Feb 2024


  • blood pressure
  • diet
  • Physical activity
  • pilot trial
  • quality of life
  • telehealth


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