BackgroundComplications after stroke have been associated with poor outcome. Modern stroke treatment might reduce the occurrence of complications. The aim of this study was to investigate whether the frequency and type of complications during the first week after stroke has changed in patients treated in a stroke unit in 2013 compared to 2003.MethodsIn total 489 patients in 2003 and 185 patients in 2013 with acute stroke were included and followed prospectively for 1 week, examining the frequency of 12 predefined complications adjusted for severity of stroke. Informed consent was given by all patients or their next of kin.ResultsMean (SD) age was 77.2 (10.2) and 76.9 (8.5) in 2003 and 2013 respectively, P = 0.455. Severity of stroke, measured by the Scandinavian Stroke Scale, was 39.5 (16.8) versus 37.0 (16.4), P = 0.011. After adjustment for stroke severity the results showed an odds ratio of 0.64 for experiencing one or more complications in the 2013 cohort versus the 2003 cohort, P = 0.035. The subgroup analysis showed that the reduction was only significant in the group with moderate stroke, with 74 % experiencing one or more complications in 2003 compared to 45 % in 2013, P < 0.001. Progressing stroke and myocardial infarction occurred significantly less frequent in 2013 than in 2003; the frequency of other complications remained unchanged.ConclusionsThe risk of experiencing one or more complications has decreased from 2003 to 2013. The reduction was most pronounced in patents with moderate stroke with a significant reduction in progressing stroke and myocardial infarction.

This study confirms the beneficial effect of upright activity applied during hospital stay in Norwegian stroke units.

Depression and anxiety are more common after stroke than in the general population. In non-stroke patients, physical activity and exercise is associated with less psychological distress. This study found that pre-stroke physical activity was associated with fewer depressive symptoms 3 months after stroke. However, being physically active was not related to symptoms of anxiety. In addition, most patients reported performing approximately the same level of physical activity before and after stroke. Despite the lack of causality, these findings indicate that pre-stroke physical activity might be protective against post-stroke depression, but not against anxiety. Objectives: To explore mechanisms affecting mental health in patients with stroke. The aims were to investigate the association between pre-stroke physical activity and symptoms of anxiety and depression 3 months after stroke, and to investigate how self-reported physical activity changed from before to 3 months after the stroke. Design: Secondary analyses of a prospective observational multicentre study. Patients: Stroke patients from 11 Norwegian stroke units. Methods: Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale, and physical activity was assessed by self-report. Negative binomial regression was used to analyse associations. Results: The analysed sample consisted of 205 patients; mean age was 74 years (standard deviation (SD) 11.5); 46% were women. Higher activity levels before stroke were associated with fewer symptoms of depression in multivariable analyses with regression coefficient of 0.84 (95% confidence interval 0.73-0.97), p = 0.015. Eighty-five (41.5%) patients reported similar activity levels before and after stroke. Conclusion: In this group of patients with mild symptoms of emotional distress, it seems that pre-stroke physical activity might be protective against poststroke depression, but not anxiety. Many patients with mild-to-moderate stroke report being equally active before and after the stroke.

BackgroundThe reported prevalence of pain after stroke varies considerably, depending on how pain is measured, time after stroke, and characteristics of the selected population. The aims of this study were to investigate the prevalence and distribution of new-onset pain initially and three months after stroke in a general Norwegian cohort, and to examine whether symptoms of anxiety or depression were associated with new-onset pain after stroke.Material and methodsStroke patients were included from eleven different hospitals within 14 days after stroke onset. Pain was assessed at inclusion and three months after stroke, and the distribution of pain was marked on a body map. New-onset pain was defined as pain reported by the patients to have occurred after the stroke. Symptoms of anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale.ResultsA total of 390 patients were included. Pain data were available in 142 patients at both inclusion and follow-up, while 245 patients had available data for the regression analysis. In patients with follow-up data, new-onset pain occurred in 14 (9.9%) patients at inclusion and in 31 (21.8%) patients three months later, P=0.005. New-onset pain in the affected upper limb and bilaterally in the lower limbs was more common at three months than initially after stroke. Symptoms of anxiety were associated with new-onset pain (OR=1.13, 95% CI 1.01–1.27, P=0.030).ConclusionThis study shows that new-onset pain occurs in one out of ten patients initially after stroke and in one out of five patients three months after stroke, and it was associated with symptoms of anxiety. This raises the question of whether easing symptoms of anxiety might help to prevent or treat new pain after stroke.