Cardiovascular rehabilitation adapted to transient ischaemic attack and stroke

INTERVENTION: Over 8 weeks: Control subjects will attend two one‐hour educational session addressing risk factor reduction and lifeskills. Intervention subjects will attend the two educational classes listed above. In addition they will attend for 16 one‐hour aerobic training sessions and will receive brief intervention counselling individually tailored to their lifestyle risk factors and readiness to change on the transtheoretical model. CONDITION: Stroke, transient ischaemic attack ; Circulatory System ; Transient cerebral ischaemic attacks and related syndromes PRIMARY OUTCOME: 1. Adherence to the European guidelines for cardiovascular disease prevention in a high risk group as evidenced by the % of smokers, fruit and vegetable intake and habitual exercise, i.e. % taking moderate to vigorous activity greater than three times a week extrapolated from the International Physical Activity Questionnaire ; 2. Cardiac Risk Score; ; Baseline measures of the primary and secondary outcomes will be taken on week 1. Reassessment will be conducted on week 10 and at a one year interval. SECONDARY OUTCOME: 1. Physical fitness: VO2 as calculated from a steady state sub‐maximal cycle ergometry test; 2. Health related quality of life as measured by the Stroke Specific Quality of Life Index, Hospital Anxiety and Depression Scale, Functional Health Status COOP/WONCA Scale; 3. Economic evaluation derived from EuroQol‐5D; ; Baseline measures of the primary and secondary outcomes will be taken on week 1. Reassessment will be conducted on week 10 and at a one year interval. INCLUSION CRITERIA: 1. Adults of either gender aged greater than 18 years of age who have sustained an ischaemic stroke (confirmed by computed tomography [CT] or magnetic resonance imaging [MRI]) or a transient ischaemic attack (TIA) 2. Cerebrovascular accident [CVA] greater than one year recruited through the community with medical consent 3. CVA less than 1 year with consent of their hospital consultant 4. TIA greater than 3 months with consent of their hospital consultant