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A lifestyle intervention as supplement to a physical activity programme in rehabilitation after stroke: a randomized controlled trial [with consumer summary]
Lund A, Michelet M, Sandvik L, Wyller T, Sveen U
Clinical Rehabilitation 2012 Jun;26(6):502-512
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 to +7.6), 'vitality' (-3.0, 95% CI -9.6 to +3.6), 'bodily pain' (+3.3, 95% CI -7.8 to +14.4), 'general health' (-1.6, 95% CI -8.4 to +5.1), 'social functioning' (-2.5, 95% CI -12.8 to +7.8), 'physical functioning' (+1.0, 95% CI -6.7 to +8.6), 'role physical' (-7.1, 95% CI -22.7 to +8.4), 'role emotional' (+11.8, 95% CI -4.4 to +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.

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