Association Between Family Support Combined With Exercise Rehabilitation and Psychological Resilience, Neurological Function and Daily Living Activities in Patients With Stroke and Anxiety

Abstract

Background: To investigate the association between family-supported combined exercise rehabilitation and psychological resilience, neurological function and daily living activities in patients with stroke and anxiety.

Methods: This retrospective study included 260 patients with stroke and anxiety disorder who attended The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College between April 2022 and April 2024. On the basis of the intervention methods documented in their medical records, they were categorised into Groups A (n = 133) and B (n = 127). Group A received routine postoperative care plus exercise rehabilitation intervention, whereas Group B received the same intervention plus additional family support intervention. Both groups underwent a 12-week intervention period. Data for psychological resilience (Connor–Davidson resilience scale [CD-RISC]), anxiety (Hamilton Anxiety Scale [HAMA]), neurological function (National Institutes of Health Stroke Scale [NIHSS]), daily living activities (Barthel Index [BI]) and motor function (Fugl–Meyer Assessment of Motor Function [FMA]) scores at baseline, Week 6 and Week 12 were extracted from medical records. Repeated measures (Analysis of Variance [ANOVA]) was employed to compare time effects, between-group effects and interactions. Two-way ANOVA examined the interaction effect between family support and exercise rehabilitation. Multivariate linear regression analysis was performed by using scores at 12 weeks postintervention as the dependent variable, baseline scores as the independent variable and group assignment as the independent variable.

Results: After 12 weeks of intervention, both groups showed increased CD-RISC, BI and FMA scores, along with decreased HAMA and NIHSS scores. Group B demonstrated superior improvement to Group A (p < 0.05). Repeated measures ANOVA revealed the significant main effects of time (F values ranging from 145.219 to 313.091 for each indicator, all p < 0.001) and between-group effects (F values ranging from 6.429 to 12.682 for each indicator, all p < 0.05). Significant interactions between time and group were observed for HAMA (F = 4.765, p = 0.009), NIHSS (F = 10.589, p < 0.001) and BI (F = 3.463, p = 0.032) scores, whereas no significant interaction was observed for CD-RISC (F = 0.728, p = 0.483) or FMA (F = 1.062, p = 0.335). Linear regression analysis indicated that after controlling for baseline scores, intervention group remained an independent predictor of change in all measures (p < 0.05).

Conclusions: In patients with stroke and anxiety disorder, the combined intervention of family support and exercise rehabilitation is associated with improved psychological resilience; alleviated anxiety symptoms; and enhanced recovery of neurological function, daily living activities and motor function. Although the patient's baseline severity of illness showed the strongest association with final recovery outcomes, family support interventions also constituted an independent favourable factor associated with improved recovery outcomes.