title: Depressive symptoms influence use of feedback for motor learning and recovery in chronic stroke.
abstract: OBJECTIVE
  Sensorimotor impairments and depressive symptoms (PSD) influence arm motor recovery post-stroke. Feedback provision improves upper limb motor learning in patients with chronic stroke but factors including PSD may affect ability to use feedback. We evaluated the influence of PSD on the ability to use auditory feedback for upper limb recovery and motor learning in patients with chronic stroke.
  
  
  METHODS
  Participants (n = 24) practiced 72 pointing movements/session (6 targets, 12 sessions, randomized) with auditory feedback on movement speed and trunk displacement. The presence of PSD (Beck's Depression Inventory; BDI-II) was assessed at pre-intervention (PRE). Arm motor impairment (Fugl-Meyer Assessment, shoulder horizontal adduction, shoulder flexion, elbow extension ranges, trunk displacement) and arm use (Motor Activity Log) were assessed at PRE, immediately after (POST) and retention (3 mos; RET). Participants were divided into two groups based on BDI-II scores: ≥ 14/63 (DEP group; n = 8; score: 20.5 ± 7.5) and ≤ 13/63 (no PSD (ND) group; n = 16; score: 5.0 ± 3.8). Changes in impairment and arm use levels were assessed (mixed-model ANOVAs).
  
  
  RESULTS
  All participants improved arm use. DEP had lower Fugl-Meyer scores, used more compensatory trunk displacement and had lower shoulder horizontal adduction range compared to ND.
  
  
  CONCLUSIONS
  The presence of PSD diminished the ability to use auditory feedback for arm motor recovery and motor learning.
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.|Feil-Oberfeld Research Centre, Jewish Rehabilitation Hospital site of Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Laval, Quebec, Canada.
authors.forename: Sandeep K
authors.initials: SK
authors.lastname: Subramanian
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.|Feil-Oberfeld Research Centre, Jewish Rehabilitation Hospital site of Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Laval, Quebec, Canada.
authors.forename: Gevorg
authors.initials: G
authors.lastname: Chilingaryan
authors.affiliation: School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Heidi
authors.initials: H
authors.lastname: Sveistrup
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.|Feil-Oberfeld Research Centre, Jewish Rehabilitation Hospital site of Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Laval, Quebec, Canada.
authors.forename: Mindy F
authors.initials: MF
authors.lastname: Levin
mesh_terms: D001132:Arm / Q000503:physiopathology; D001307:Auditory Perception; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D003863:Depression / Q000503:physiopathology; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D007858:Learning / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D011569:Psychiatric Status Rating Scales; D020127:Recovery of Function; D012720:Severity of Illness Index; D020521:Stroke / Q000503:physiopathology / Q000523:psychology*; D000071939:Stroke Rehabilitation; D060726:Torso / Q000502:physiology; D016896:Treatment Outcome
keywords: Rehabilitation; cerebrovascular accident; kinematics; knowledge of performance; knowledge of results; mood; upper limb