Conclusions Stroke secondary prevention lifestyle interventions are effective in terms of affecting positive change in relation to lifestyle behaviours , physiological and secondary outcomes .
However , there was insufficient evidence to determine the effect of intervention on incidence of stroke recurrence .
EXECUTIVE SUMMARY Background Each year , approximately 15 million people worldwide have a stroke ; of these , five million die and another five million are chronically disabled .
Stroke recurs in approximately 25 % of patients during the first five years post-stroke ; recurrence may result in death , increased disability or institutionalisation .
Modifiable risk factors for recurrent stroke have been identified , and may be addressed by means of behavioural health promotion interventions .
Objectives This systematic review sought to establish the effectiveness of secondary prevention behavioural interventions , which address one or more modifiable lifestyle risk factors for recurrent stroke i.e. tobacco use , unhealthy diet , physical inactivity and excessive alcohol consumption .
Daily Functioning and Quality of Life in a Randomized Controlled Trial of Therapeutic Exercise for Subacute Stroke Survivors
Background and Purpose — The ability of therapeutic exercise after stroke to improve daily functioning and quality of life ( QOL ) remains controversial . We examined treatment effects on these outcomes in a r and omized controlled trial ( RCT ) of  exercise  in subacute stroke survivors . Methods — This is a secondary analysis of a single-blind RCT of a 12-week program versus usual care . Baseline , post-treatment and 6-month post-treatment daily functioning and QOL were assessed by Barthel index , Functional Independence Measure , instrumental activities of daily living , Medical Outcomes Study short-form 36-item question naire ( SF-36 ) , and Stroke Impact Scale ( SIS ) . Results — Of 100 r and omized subjects , 93 completed the postintervention assessment , ( mean age 70 ; 54 % male ; 81 % white ; mean Orpington Prognostic Score 3.4 ) , and 80 had 6-month post-treatment assessment . Immediately after intervention , the intervention group improved more than usual care in SF-36 social function ( 14.0 points ; P=0.0051 ) and in SIS ( strength [ 9.2 points ; P=0.0003 ] , emotion [ 5.6 points ; P=0.0240 ] , social participation [ 6.6 points ; P=0.0488 ] , and physical function [ 5.0 points ; P=0.0145 ] ) . Treatment was marginally more effective on Barthel score ( 3.3 points ; P=0.0510 ) , SF-36 ( physical function [ 6.8 points ; P=0.0586 ] , physical role function [ 14.4 points ; P=0.0708 ] ) , and SIS upper extremity function ( 7.2 points ; P=0.0790 ) . Effects were diluted 6 months after treatment ended . Conclusion — This rehabilitation exercise program led to more rapid improvement in aspects of physical , social , and role function than usual care in persons with subacute stroke . Adherence interventions to promote continued exercise after treatment might be needed to continue benefit
Conclusions Stroke secondary prevention lifestyle interventions are effective in terms of affecting positive change in relation to lifestyle behaviours , physiological and secondary outcomes .
However , there was insufficient evidence to determine the effect of intervention on incidence of stroke recurrence .
EXECUTIVE SUMMARY Background Each year , approximately 15 million people worldwide have a stroke ; of these , five million die and another five million are chronically disabled .
Stroke recurs in approximately 25 % of patients during the first five years post-stroke ; recurrence may result in death , increased disability or institutionalisation .
Modifiable risk factors for recurrent stroke have been identified , and may be addressed by means of behavioural health promotion interventions .
Objectives This systematic review sought to establish the effectiveness of secondary prevention behavioural interventions , which address one or more modifiable lifestyle risk factors for recurrent stroke i.e. tobacco use , unhealthy diet , physical inactivity and excessive alcohol consumption .