What is the benefit of a high-intensive exercise program on health-related quality of life and depression after stroke? A randomized controlled trial

Abstract

The aim of the study was to evaluate the impact of a high-intensive exercise program containing high-intensive functional exercises implemented to real-life situations together with group discussions on falls and security aspects in stroke subjects with risk of falls. This was a pre-specified secondary outcome for this study. For evaluation, Short Form-36 (SF-36) health-related quality of life (HRQoL) and the Geriatric Depression Scale-15 (GDS-15) were used. This was a single-center, single-blinded, randomized, controlled trial. Consecutive ≥55 years old stroke patients with risk of falls at 3–6 months after first or recurrent stroke were randomized to the intervention group (IG, n=15) or to the control group (CG, n=19) who received group discussion with focus on hidden dysfunctions but no physical fitness training. The 5-week high-intensive exercise program was related to an improvement in the CG in the SF-36 Mental Component Scale and the Mental Health subscale at 3 months follow-up compared with baseline values while no improvement was seen in the IG at this time. For the SF-36 Physical Component Scale, there was an improvement in the whole study group at 3 and 6 months follow-up compared with baseline values without any significant changes between the IG and CG. The GDS-15 was unchanged throughout the follow-up period for both groups. Based on these data, it is concluded that high-intensive functional exercises implemented in real-life situations should also include education on hidden dysfunctions after stroke instead of solely focus on falls and safety aspects to have a favorable impact on HRQoL.

Key words::

• Accidental falls
• cerebrovascular disorders
• depression
• exercise
• quality of life
• rehabilitation

Acknowledgements

This study was supported by grants from Vårdalinstitutet, the Swedish Institute for Health Sciences, the Swedish Stroke Foundation, the Swedish Heart and Lung Foundation, the Northern Swedish Stroke fund, the “Spjutspetsprojekt” at the County of Västerbotten, the Medical Faculty of Umeå University,Umeå University Hospital and the Erik and Anne-Marie Detlof Foundation at Umeå University. We thank the Clinical Research Center at the University Hospital of Umeå for use of their facilities for our assessments. We also thank the following staff for help with the study: Rolf Backlund, Maria Hällgren, Monica Edström, Annelie Selling, Mats Bergström, Lena Sjölund, StinaOlofsson, JosefinCroxatto and Katarina Klingberg. We also thank the subjects and caregivers for their contributions and Anders Lundquist for assistance with the statistical analyses.

The study is registered at www.clinicaltrials.gov (NCT00377689).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.