Weight gain following stroke : its everybody's business

Introduction: Approximately 900,000 people in England live with the effects of stroke (NICE 2010). Health behaviour modification can be crucial in stroke rehabilitation. Local stakeholders identified a problem of increased numbers of patients experiencing long term weight gain following a stroke. Method: Mixed method study incorporating i) survey of South Yorkshire Health Cohort participants (n=87); ii) interviews with staff (n=18) and stroke patients (n=10). Data analysed using framework analysis. Results: Weight gain post stroke is not monitored routinely and prevalence is therefore unknown. Findings from this study indicate that post-stroke weight gain is a problem for some people. Contributing factors identified include social isolation, depression and loss of control in cognition and communication affecting ability to manage diet and weight. Ambiguity was seen to arise because weight gain following stroke can be both a sign of progress and of a problem. Results indicate fragmented communication between health care professionals across care pathways limits opportunities to address weight gain. Additional limiting factors include limited availability of specialist support and funding cuts to community based services. Conclusion: Health care professionals need to be mindful of the risk of long term weight gain following stroke. Whether in acute, intermediate, rehabilitation or primary care settings, systems should be in place to identify opportunities for advice and support regarding diet and physical activity by, for example, embracing initiatives such as Making Every Contact Count (MECC). A large cohort study would provide population based data on prevalence and causes of weight gain following a stroke.