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A randomized controlled trial to assess the psychosocial effects of early exercise engagement in patients diagnosed with transient ischaemic attack and mild, non-disabling stroke [with consumer summary]
Faulkner J, McGonigal G, Woolley B, Stoner L, Wong L, Lambrick D
Clinical Rehabilitation 2015 Aug;29(8):783-794
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; 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 examine the effect of an early exercise and education programme on psychosocial health of transient ischaemic attack (TIA) and mild, non-disabling stroke patients. DESIGN: Randomized, parallel-group, clinical trial. SETTING: Hospital and academic institution. PARTICIPANTS: A total of 55 newly diagnosed transient ischaemic attack/mild stroke patients (mean (SD) 69 (11) y). INTERVENTION: Participants were randomized to either an eight-week, twice weekly, 90-minute exercise and education programme (experimental group) or to a usual care control group. MAIN MEASURES: Psychosocial measures (SF-36, Hospital Anxiety and Depression Scale, Profile of Mood States, International Physical Activity Questionnaire, Stroke Awareness Questionnaire) were assessed at baseline and eight-week and 12-month follow-up. RESULTS: The experimental group demonstrated improvements in the Physical Component Score (mean (SD) 44.1% (11.7) to 47.4% (11.3)), Vitality (46.5% (12.4) to 54.2% (14.2)), Physical Functioning (45.6% (10.7) to 51.9% (14.7)), Role Physical (38.7% (10.8) to 43.1% (13.6)) and Global Health (49.1% (10.3) to 54.4% (13.6)) from the SF-36, at the eight-week follow-up assessment (p < 0.05). There were no further changes in these measures between the eight-week and 12-month follow-up assessment (p > 0.05). The experimental group demonstrated a greater awareness of the signs and symptoms associated with stroke (p < 0.05). There were no differences in the Mental Component Score (SF-36), the Hospital Anxiety and Depression Scale or the International Physical Activity Questionnaire between treatment groups (p > 0.05). CONCLUSION: Early engagement in an exercise and education programme may improve physical health perceptions in transient ischaemic attack/mild stroke patients. However, secondary prevention exercise and education programmes warrant further research with regards to their effects on perceptions of mental health in this population group.

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