title: The effect of very early mobilisation after stroke on psychological well-being.
abstract: OBJECTIVE
  The immobility common to patients after acute stroke has the potential to increase negative mood symptoms. We evaluated the effect of very early mobilization after stroke on levels of depression, anxiety and irritability.
  
  
  METHODS
  AVERT is a randomized controlled trial; patients in the very early mobilization group receive mobilization earlier (within 24 h of stroke) and more frequently than patients in the standard care group.
  
  
  METHODS
  Seventy-one patients with confirmed stroke were included.
  
  
  METHODS
  Patients were assessed on the Irritability, Depression and Anxiety (IDA) scale at multiple time-points.
  
  
  RESULTS
  At 7 days, very early mobilization patients were less depressed (z=2.51, p=0.012) and marginally less anxious (z=1.79, p=0.073) than standard care patients (Mann-Whitney test). Classifying IDA scores as normal or depressed, and using backward stepwise multivariable logistic regression, very early mobilization was associated with a reduced likelihood of depression at 7 days (odds ratio 0.14, 95% confidence interval 0.03-0.61; p=0.009).
  
  
  CONCLUSIONS
  Very early mobilization may reduce depressive symptoms in stroke patients at 7 days post-stroke.
authors.affiliation: Neurosciences Building, Heidelberg Repatriation Hospital, 300Waterdale Rd, Heidelberg Heights, Victoria 3081, Australia. tcumming@nsri.org.au
authors.forename: Toby B
authors.initials: TB
authors.lastname: Cumming
authors.forename: Janice
authors.initials: J
authors.lastname: Collier
authors.forename: Amanda G
authors.initials: AG
authors.lastname: Thrift
authors.forename: Julie
authors.initials: J
authors.lastname: Bernhardt
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis; D003863:Depression / Q000175:diagnosis; D004434:Early Ambulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007508:Irritable Mood; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D020521:Stroke / Q000523:psychology; D000071939:Stroke Rehabilitation; D013997:Time Factors