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Rodolfo T. Rafael, M.D. 
 

 

 

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Role of exercise to poststroke depressive symptoms

 
Clinical Question:
Does exercise help to reduce poststroke depressive symptoms?

Bottom Line:
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.

Reference:
Therapeutic exercise and depressive symptoms after stroke.Lai SM, Studenski S, Richards L, Perera S, Reker D, Rigler S, Duncan PW. J Am Geriatr Soc. 2006 Feb;54(2):240-7.

Study Design:
Randomized Controlled Trial

Synopsis:
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. Planned secondary analysis of the data from a 9-month randomized, controlled trial. Participants are one hundred stroke survivors who had completed acute rehabilitation. A progressive, structured, 3-month physical exercise program was done. They measure demographics, stroke characteristics, impairments, functional limitations, the Geriatric Depression Scale, the Stroke Impact Scale, and the Medical Outcomes Study 36-Item Short Form. 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.

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