A pilot randomized controlled trial of self-help relaxation to reduce post-stroke depression.

OBJECTIVE: To consider the potential of self-help relaxation training to treat depression after stroke. DESIGN: Randomized controlled trial with cross-over at three months. SETTING: Community. PARTICIPANTS: In total, 21 people with stroke, aged 49-82 years. INTERVENTION: Autogenic relaxation CD. MAIN MEASURE: Hospital Anxiety and Depression Scale-Depression (HADS-D) subscale. RESULTS: No difference in depression change scores was identified between the treatment and control groups; however, on two follow-ups, significant positive differences relative to screening were found for the treatment group (at 2 months Z = -2.55, P = .011 and 12 months Z = -2.44, P = .015). A partial η2 = .07 was identified. CONCLUSION: Self-help relaxation holds promise as a self-help treatment for depression after stroke. Findings from this trial, considered with others of relaxation for depression, suggest that a study including a total of 80 participants would likely be sufficient to establish efficacy of the treatment, relative to controls, in those with stroke.

Twelve month follow-up on a randomised controlled trial of relaxation training for post-stroke anxiety.

OBJECTIVE: To follow up participants in a randomised controlled trial of relaxation training for anxiety after stroke at 12 months. DESIGN: Twelve month follow-up to a randomised controlled trial, in which the control group also received treatment. SETTING: Community. PARTICIPANTS: Fifteen of twenty one original participants with post-stroke anxiety participated in a one year follow-up study. INTERVENTIONS: A self-help autogenic relaxation CD listened to five times a week for one month, immediately in the intervention group and after three months in the control group. MAIN MEASURES: Hospital Anxiety and Depression Scale-Anxiety subscale and the Telephone Interview of Cognitive Status for inclusion. Hospital Anxiety and Depression Scale-Anxiety subscale for outcome. All measures were administered by phone. RESULTS: Anxiety ratings reduced significantly between pre and post-intervention, and between pre-intervention and one year follow-up ( χ2(2) = 22.29, p < 0.001). CONCLUSIONS: Reductions in anxiety in stroke survivors who received a self-help autogenic relaxation CD appear to be maintained after one year.

Self-help relaxation for post-stroke anxiety: a randomised, controlled pilot study.

OBJECTIVE: To consider relaxation as a potential treatment for anxiety in stroke survivors living in the community, including feasibility and acceptability. DESIGN: Randomised two group design (intervention and control). PARTICIPANTS: All participants (n = 21) were stroke survivors living in the community who reported experiencing anxiety (Hospital Anxiety and Depression Scale - Anxiety Subscale ⩾ 6). INTERVENTIONS: The intervention group were asked to listen to a self-help autogenic relaxation CD, five times a week, for at least one month. Participants completed the Hospital Anxiety and Depression Scale at screening and then monthly for three months. RESULTS: At each assessment following screening, participants who received the relaxation training were significantly more likely to report reduced anxiety compared to those who had not received the training (Month 1 P = 0.002; Month 2 P < 0.001; Month 3 P = 0.001). After one month, seven of the intervention group (n = 10) had completed the relaxation training as directed and planned to continue using it. The intervention appeared practical to deliver and relatively inexpensive, with minimal adverse effects. CONCLUSIONS: Preliminary evidence suggests that autogenic relaxation training delivered in a self-help CD format is a feasible and acceptable intervention, and that anxiety is reduced in stroke survivors who received the intervention. Future studies should seek to recruit a larger and more heterogeneous sample of 70 participants.