Depression, Anxiety, Loneliness, Post Traumatic Stress Disorder, Stress, Psychological, Stroke
Conditions
Keywords
stroke, rehabilitation, social support, cognitive functions, activity
Brief summary
Outpatient participants with a recent stroke diagnoses receive complimentary rehabilitation. The nature interventions include ergo- and physiotherapeutic and neurocognitive tasks with the support of an psychotherapeutic frame designed to be performed in a nature environment.
Detailed description
Patients with an acute stroke are recruited to the study when signing out from the acute hospital care services. The patients are selected randomly into two groups: intervention and control groups in proportions 1:1. During the four-week study period the partipants in the control group are encouraged to maintain light physical activity 1 to 3 times per week with or without company. The research worker contacts the participants every week. In the nature group the research worker organises individual nature visits in the nearby nature twice a week and encourages the participants to go outdoors with a close-one once a week. All interventional contacts in the nature group are performed in a ecopsychotherapeutical frame consisting of ergo- and physiotherapeutic and neurocognitive tasks.
Interventions
BEHAVIORALTherapies in nature
Therapeutic tasks in nature specifically designed for the study
Sponsors
University of Helsinki
University of Jyvaskyla
Tampere University
Joint Authority for Päijät-Häme Social and Health Care
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
randomised controlled study
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Acute stroke
Exclusion criteria
* Traumatic intracranial bleeding without stroke * A malign, aggressive disease * Severe aphasia or incapable of independent decision making
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The effect of nature interventions on PROMIS questionnaire | 4 weeks | Self-assessed quality of life assessed by a PROMIS (patient-reported outcomes measurement information system) questionnaire. Time points measured wk 0 and wk 4, efficacy evaluated on the basis of the difference between these time points. An increase in the obtained score is considered a positive effect. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The effect of nature interventions on moods assessed by GAD7 | 4 weeks | Evaluation of anxiety scales by a GAD7 (generalised anxiety disorder 7) interview, the score of the questionnaire (0-21 points) is evaluated wk 0 and wk 4. A decrease in the total score is considered as a positive effect on moods. |
| The effect of nature-based intervention on neurocognitive functions in COMET questionnaire | 4 wk | Assessment of the efficacy of nature-based neuropsychological tasks on neurocognitive functions by a cognitive test COMET (cognitive method) -questionnaire. The total score is evaluated wk0 and wk4. An increase in the total score is considered a positive effect. |
Other
| Measure | Time frame | Description |
|---|---|---|
| The effect of nature interventions on functional ability assessed by a validated questionnaire WHODAS | 4 weeks | Self-assessed functional ability in everyday life with a validated questionnaire WHODAS (WHO disability assessment scale). The total scores are evaluated wk0 and wk4. An increase in the total score is considered a positive effect. |
| The effect of nature interventions on microbiome | 4 weeks | Microbiological analyses from skin flake and stool samples |
| The effect of nature interventions on the activity of autonomic nervous system | 4 weeks | The evaluation of the state of the autonomic nervous system by heart rate variability by a portable device. |
Countries
Finland
Contacts
Primary ContactHanna Haveri, MD PhD
Backup ContactMarja Mikkelsson, Prof
Outcome results
None listed