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Longitudinal changes in activity participation in the first year post-stroke and association with depressive symptoms.
- Source :
-
Disability & Rehabilitation . Oct2019, Vol. 41 Issue 21, p2548-2555. 8p. 2 Diagrams, 4 Charts, 1 Graph. - Publication Year :
- 2019
-
Abstract
- Research question: 1. Does activity participation improve over time in the first year after stroke? 2. What is the association of depressive symptoms on retained activity participation 12-months post-stroke adjusting for neurological stroke severity and age? 3. Is an improvement in activity participation associated with a decrease in depressive symptoms between 3- and 12-months post-stroke? Design: Longitudinal observational study of activity participation and depressive symptoms in ischemic stroke survivors. Participants: A total of 100 stroke survivors with mild neurological stroke severity. Methods: A total of 100 stroke survivors were recruited from five metropolitan hospitals and assessed at 3- and 12-months post-stroke using measures of activity participation (Activity Card Sort-Australia (ACS-Aus)) and depressive symptoms (Montgomery–Asberg Depression Rating Scale Structured Interview Guide (MADRS-SIGMA)). Results: There was a significant association between time (pre-stroke to 3-months post-stroke) and current activity participation (−5.2 activities 95% CI −6.8 to −3.5, p < 0.01) and time (pre-stroke to 12-months) and current activity participation (−2.1 activities 95% CI −3.7 to −0.5, p = 0.01). At 12-months post-stroke, a one-point increase in depressive symptoms was associated with a median decrease of 0.3% (95% CI −1.4% to −0.1%, p = 0.02) of retained overall activity participation, assuming similar neurological stroke severity and age. A decrease in depressive symptoms between 3- and 12-months post-stroke was associated with an improvement of 0.31 (95% CI −0.5 to −0.1, p = 0.01) in current activity participation. Conclusions: Activity participation improves during the first year of recovery post-stroke in stroke survivors with mild neurological stroke severity and is associated with depressive symptoms over time and at 12-months post-stroke. Improvements in participation occur in the first 3-months post-stroke and continue to a lesser degree in the first year after stroke. Depressive symptoms are associated with lower participation at 12-months. A multidimensional approach targeting depressive symptoms and increasing participation in the early months post-stroke and throughout the first-year after stroke is recommended to increase overall recovery following stroke. A focus on increasing leisure activity participation is recommended to improve depressive symptoms. [ABSTRACT FROM AUTHOR]
- Subjects :
- *STROKE
*CONFIDENCE intervals
*CONVALESCENCE
*MENTAL depression
*LONGITUDINAL method
*NEUROLOGICAL disorders
*SCIENTIFIC observation
*PSYCHOLOGICAL tests
*RESEARCH
*RESEARCH funding
*URBAN hospitals
*MULTIPLE regression analysis
*SEVERITY of illness index
*PHYSICAL activity
*DESCRIPTIVE statistics
*NIH Stroke Scale
*PSYCHOLOGY
Subjects
Details
- Language :
- English
- ISSN :
- 09638288
- Volume :
- 41
- Issue :
- 21
- Database :
- Academic Search Index
- Journal :
- Disability & Rehabilitation
- Publication Type :
- Academic Journal
- Accession number :
- 138400071
- Full Text :
- https://doi.org/10.1080/09638288.2018.1471742