Brain Injury, February 2008; 22(2): 135–145 Exercise and health-related quality of life during the first year following acute stroke. A randomized controlled trial BIRGITTA LANGHAMMER 1 , JOHAN K. STANGHELLE 2 , & BIRGITTA LINDMARK 3 1 Faculty of Health, Physiotherapy Programme, Oslo University College, Oslo, Norway, 2 Faculty of Medicine, Sunnaas Rehabilitation Hospital, University of Oslo, Nesoddtangen, Norway, and 3 Department of Neurosciences, Section of Physiotherapy, University Hospital, Uppsala University, Uppsala, Sweden (Received 11 October 2007; accepted 6 January 2008) Abstract Purpose: To evaluate the impact of two different physiotherapy exercise regimes in patients after acute stroke on health- related quality of life (HRQoL) and to investigate how the degree of motor and balance function, gait capacity, activities of daily living and instrumental activities of daily living influenced HRQoL. Methods: A longitudinal randomized controlled stratified trial of two interventions: the intensive exercise groups with scheduled intensive training during four periods of the first year after stroke and the regular exercise group with self-initiated training. Results: There was a tendency of better HRQoL in the regular exercise group on NHP total score (p ¼ 0.05). Patients with low scores in activities of daily living, balance and motor function and inability to perform 6-minute walk test on admission, scored lower on self-perceived health than patients with high scores and ability to perform the walking test. At 1 year post-stroke, total scores on NHP were moderately associated with motor function (r ¼0.63), balance (r ¼0.56), gait (r ¼0.57), activities of daily living (r ¼0.57) and instrumental activities of daily living (r ¼0.49–0.58). The physical mobility sub-scale of NHP had the strongest association ranging from r ¼0.47–0.82. Conclusion: The regular exercise group with self-initiated training seemed to enhance HRQoL more than the intensive exercise group with scheduled intensive training. The degree of motor function, balance, walking capacity and independence in activities of daily living is of importance for perceived HRQoL. Keywords: Excercise, health related quality of life, level of function, physical therapy, stroke Introduction Stroke is a major cause of long-term disability which may handicap patients in everyday life and thus lead to deterioration of their quality of life (QoL) in several areas [1]. As stroke mortality rates are declining [2], afflicted individuals are increasingly likely to live with their residual impairments and disabilities. Impairments and disabilities will influ- ence QoL in patients with stroke in one way or another [2]. However, QoL is a broad concept and covers such areas as social, environmental, economic and health satisfaction. Health-related quality of life (HRQoL), on the other hand, is less wide and includes the self-perceived consequences of mental and physical health on the person’s life [3]. HRQoL in stroke survivors is reported lower than in the average population [3–5]. It is therefore of impor- tance to evaluate HRQoL in order to assess and improve the possibilities for patients with stroke to return to the community [6–14]. However, data on HRQoL in stroke trials are modest, especially reports of the longitudinal aspect [3–5]. On the other hand, the goals in stroke rehabilitation are often related to HRQoL. It has been generally Correspondence: Birgitta Langhammer, Physiotherapist/PhD student, Faculty of Health, Physiotherapy Programme, Oslo University College, Box 4, St Olavs pl, 0130 Oslo 4, Norway. Tel: þ47 22 45 25 10. Fax: þ47 22 45 25 05. E-mail: birgitta.langhammer@hf.hio.no ISSN 0269–9052 print/ISSN 1362–301X online ß 2008 Informa UK Ltd. DOI: 10.1080/02699050801895423