Therapeutic exercise and depressive symptoms after stroke.
OBJECTIVE
To examine the effect of exercise on depressive symptoms and the effect of baseline depressive symptoms on the benefits from exercise in stroke survivors who have completed acute rehabilitation.


METHODS
Planned secondary analysis of the data from a 9-month randomized, controlled trial.


METHODS
Participant homes.


METHODS
One hundred stroke survivors who had completed acute rehabilitation.


METHODS
A progressive, structured, 3-month physical exercise program.


METHODS
Demographics, stroke characteristics, impairments, functional limitations, the Geriatric Depression Scale, the Stroke Impact Scale, and the Medical Outcomes Study 36-Item Short Form.


RESULTS
Baseline rates of depressive symptoms and other stroke sequelae were similar between the two arms. Ninety-three participants were assessed immediately after the intervention (3 months after enrollment), and 80 were assessed 9 months after enrollment. Six (14%) of the exercise group and 16 (35.6%) of the usual-care group had depressive symptoms at 3 months (P = .03). At 9 months, three (7.5%) of the exercisers had significant depressive symptoms compared with 10 (25%) who received usual care (P = .07). Participants with and without baseline depressive symptoms had equivalent treatment-related gains in impairments and functional limitations, but only participants with depressive symptoms had improved quality of life.


CONCLUSIONS
Exercise may help reduce poststroke depressive symptoms. Depressive symptoms do not limit gains in physical function due to exercise. Exercise may contribute to improved quality of life in those with poststroke depressive symptoms.
Lai
Sue-Min
SM
Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas 66160, USA. slai@kumc.edu
Studenski
Stephanie
S
Richards
Lorie
L
Perera
Subashan
S
Reker
Dean
D
Rigler
Sally
S
Duncan
Pamela W
PW
D000368:Aged; D003866:Depressive Disorder / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011788:Quality of Life; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications*; D016896:Treatment Outcome