Motor and functional recovery in patients with post-stroke depression.
OBJECTIVE
Depression is very common following stroke. Correlation between post-stroke depression (PSD) and functional outcome has been shown, but differential impact both on functional and motor recovery has not been deeply investigated. This study evaluates the influence of PSD on motor and functional outcome.


METHODS
One hundred and seventeen acute stroke patients were selected in an intensive rehabilitation department, and divided into two groups according to the presence of PSD (PSD+ and PSD-). Screening measures were DSM-IV criteria, the Geriatric Depression Scale and the Cornell Scale. Outcomes were evaluated on the basis of the Barthel Index (BI) and the Fugl-Meyer Assessment Scale (FMA). Measurements were performed at admission to the department T1), discharge (T2) and follow up (T3) in a whole period of 3 months from stroke.


RESULTS
Both groups showed a significant improvement in all outcome measures. Improvement differences were not significant on FMA scores in either group at each assessment; the PSD group had a significant higher improvement on BI score at follow-up. According to the logistic model, from T1 to T2 and from T1 to T3, only motor recovery shows a significant relation with functional recovery; from T2 to T3 PSD is the only significant factor related to functional recovery.


CONCLUSIONS
PSD is not an influencing factor for motor recovery. Results show a negative impact of PSD on the functional recovery process after discharge and not during hospitalisation. Discharge appears to be critical step for management of PSD.
Nannetti
Luca
L
Department of Rehabilitation Medicine, Prato Hospital, Prato, Italy. luca.nannetti@tin.it
Paci
Matteo
M
Pasquini
Jacopo
J
Lombardi
Bruna
B
Taiti
Piero G
PG
D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015897:Comorbidity; D003863:Depression / Q000188:drug therapy / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
D000928:Antidepressive Agents