Smartwatch-Guided Secondary Prevention After Stroke

To meet the study's objectives, 50 patients who have recently suffered a stroke or a transient ischemic attack (TIA) (< 30 days) will be recruited at Brest University Hospital.

Participation in this study will last 12 weeks. It consists of 3 visits, described below:

=> Visit #1: Enrollment (hospital)

Enrollment will take place during a routine hospital visit. The investigator will obtain the patient's written consent. Randomization will then be performed to assign the patient to a group ("active" or "passive" watch).

For all patients ("active" and "passive" watch groups):

• Program led by nurses, conducted as part of routine care following a recent ischemic stroke or TIA (secondary prevention).
• Issuance of a smartwatch and a smartphone
• Data collection (sociodemographic information, medical history, current treatments, risk factors)
• Questionnaires
• Clinical examination, neurological examination, and blood draw.

For patients in the "passive" smartwatch group:

o The smartwatch will collect data passively, without notifications.

For patients in the "active" smartwatch group:

• Setting daily step goals and assessing potential obstacles
• Scheduling regular calls (twice a week) for the duration of the study.

• Visit #2: Phone call

For all patients (both "active" and "passive" watch):

• Phone contact to collect data on changes in risk factors and the occurrence of events of interest (stroke, TIA, and cardiovascular events).
• Questionnaires

• Visit #3: End of study (hospital)

The end-of-study visit will take place at the hospital during a scheduled routine care appointment:

• Assessment with a nurse as part of the secondary prevention program (routine care)
• Data collection (risk factors)
• Questionnaires
• Clinical examination, neurological examination, and blood draw
• Return of the smartwatch and smartphone

Inclusion criteria

• Age ≤ 40-75
• Patients with recent minor ischemic stroke or TIA, initial NIHSS ≤5 (< 30 days)
• mRS ≤2 before stroke and on discharge
• Patient with Wifi access (for data transmission)
• Able to understand smartwatch instructions
• Written informed consent
• Ambulatory ≥10 meters without assistance and without walking aid
• Expected to live at home during the study period.

Exclusion criteria

• Patients with transient neurological deficits resolving within one hour and normal brain imaging will be excluded
• Not affiliated to social security
• Patient under legal protection or deprived of liberty by a judicial or administrative decision
• Patient whose follow-up will be impossible
• Cognitive impairment interfering with participation (e.g., MoCA <20).
• Unstable cardiac conditions preventing walking goals.
• Major visual or upper limb impairment preventing use of the smartwatch.
• Life expectancy <1 year.
• Already highly active (>10,000 steps/day, or about 1.5 hours of walking).
• Participation in competing interventional trials.