A lifestyle intervention as supplement to a physical activity programme in rehabilitation after stroke: a randomized controlled trial

Abstract

Objective: To evaluate the effectiveness of lifestyle group intervention on well-being, occupation and social participation.

Design: A randomized controlled trial.

Setting: Senior centres in the community.

Subjects: Of 204 stroke survivors screened, 99 (49%) were randomized three months after stroke whereby 86 (87%) participants (mean (SD) age 77.0 (7.1) years) completed all assessments (39 in the intervention group and 47 in the control group).

Intervention: A lifestyle course in combination with physical activity (intervention group) compared with physical activity alone (control group). Both programmes were held once a week for nine months.

Main outcome measure: The Short Form Questionnaire (SF-36), addressing well-being and social participation. Assessments were performed at baseline and at nine months follow-up.

Results: We found no statistically significant differences between the groups at the nine months follow-up in the SF-36. Adjusted mean differences in change scores in the eight subscales of SF-36 were; 'mental health' (+1.8, 95% confidence interval (CI) -4.0, +7.6), 'vitality' (-3.0, 95% CI -9.6, +3.6), 'bodily pain' (+3.3, 95% CI -7.8, +14.4), 'general health' (-1.6, 95% CI -8.4, +5.1), 'social functioning' (-2.5, 95% CI -12.8, +7.8), 'physical functioning' (+1.0, 95% CI -6.7, +8.6), 'role physical' (-7.1, 95% CI -22.7, +8.4), 'role emotional' (+11.8, 95% CI -4.4, +28.0).

Conclusions: Improvements were seen in both groups, but no statistically significant differences were found in the intervention group compared to controls. An intervention comprising regular group-based activity with peers may be sufficient in the long-term rehabilitation after stroke.