A Trial of Nature-based Post-stroke Fatigue Rehabilitation (NASTRU)

A Randomized Controlled Trial of Nature-based Post-stroke Fatigue Rehabilitation (NASTRU)

The aim of NASTRU was to examine whether ten weeks of nature-based rehabilitation, as add-on to standard management, could influence post-stroke fatigue (primary outcome), depression, work ability or functional outcome (secondary outcomes), compared to controls.

Patients randomized to the intervention undergo a rehabilitation program in groups up to 8 patients in an especially designed garden at the Swedish University of Agricultural Sciences, Alnarp. The intervention is grounded in environmental psychology and occupational therapy, supported by a multimodal rehabilitation team that utilizes the garden/nature for sensory stimulation, body awareness, meaningful occupations and nature experiences.

The enrollment of 101 patients (51 intervention; 50 control) was completed on August 2014. Follow-up is on-going, with assessments by examiner blinded to treatment group, at end of intervention period, 8 months, and 14 months after randomization. A parallel study with qualitative in-depth interviews in a subset of patients, who were randomized to the intervention group, as well as the staff, is also ongoing.

Inclusion Criteria:

• Ischemic or haemorrhagic stroke
• First ever or recurrence, about 3 months (group 1) or more than one year prior to screening (group 2)
• Age: 55-80 years

Exclusion criteria:

• Dementia
• Severe communication disorder that made it difficult to participate and/or serious illnesses besides stroke (for example, serious cancer disease)