Post-stroke Fatigue and Depressive Symptoms Are Differentially Related to Mobility and Cognitive Performance

MacIntosh, Bradley J.; Edwards, Jodi D.; Kang, Mani; Cogo‐Moreira, Hugo; Chen, Joyce L.; Mochizuki, George; Herrmann, Nathan; Swardfager, Walter

doi:10.3389/fnagi.2017.00343

Cited by 50 publications

(31 citation statements)

References 42 publications

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“…This finding is also in line with previous research [24]. PSF and post-stroke depression also share common risk factors, such as premorbid psychiatric illness, social isolation and functional impairments [25]. Even though fatigue and depression might be related, fatigue can also occur without depression [26].…”

Section: Discussionsupporting

confidence: 91%

Trajectories of fatigue among stroke patients from the acute phase to 18 months post-injury: A latent class analysis

et al. 2020

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IntroductionPost-stroke fatigue (PSF) is a common symptom affecting 23-75% of stroke survivors. It is associated with increased risk of institutionalization and death, and it is of many patients considered among the worst symptoms to cope with after stroke. Longitudinal studies focusing on trajectories of fatigue may contribute to understanding patients' experience of fatigue over time and its associated factors, yet only a few have been conducted to date.

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Section: Discussionsupporting

confidence: 91%

Trajectories of fatigue among stroke patients from the acute phase to 18 months post-injury: A latent class analysis

et al. 2020

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“…Additionally, the subacute population had on average higher depressive symptomology (15.1 against 11.2) and less years of schooling (4.6 against 6.0). Both these factors have been associated with poorer cognitive performance ( Zahodne et al, 2015 ; MacIntosh et al, 2017 ). However, the subacute population did better in the performance of ADLs as measured by the CAHAI.…”

Section: Discussionmentioning

confidence: 99%

Combined Cognitive-Motor Rehabilitation in Virtual Reality Improves Motor Outcomes in Chronic Stroke – A Pilot Study

et al. 2018

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Stroke is one of the most common causes of acquired disability, leaving numerous adults with cognitive and motor impairments, and affecting patients’ capability to live independently. Virtual Reality (VR) based methods for stroke rehabilitation have mainly focused on motor rehabilitation but there is increasing interest toward the integration of cognitive training for providing more effective solutions. Here we investigate the feasibility for stroke recovery of a virtual cognitive-motor task, the Reh@Task, which combines adapted arm reaching, and attention and memory training. 24 participants in the chronic stage of stroke, with cognitive and motor deficits, were allocated to one of two groups (VR, Control). Both groups were enrolled in conventional occupational therapy, which mostly involves motor training. Additionally, the VR group underwent training with the Reh@Task and the control group performed time-matched conventional occupational therapy. Motor and cognitive competences were assessed at baseline, end of treatment (1 month) and at a 1-month follow-up through the Montreal Cognitive Assessment, Single Letter Cancelation, Digit Cancelation, Bells Test, Fugl-Meyer Assessment Test, Chedoke Arm and Hand Activity Inventory, Modified Ashworth Scale, and Barthel Index. Our results show that both groups improved in motor function over time, but the Reh@Task group displayed significantly higher between-group outcomes in the arm subpart of the Fugl-Meyer Assessment Test. Improvements in cognitive function were significant and similar in both groups. Overall, these results are supportive of the viability of VR tools that combine motor and cognitive training, such as the Reh@Task. Trial Registration: This trial was not registered because it is a small clinical study that addresses the feasibility of a prototype device.

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“…The use of medications for depression or anxiety might confound the effect of PA on depression and anxiety, and our analyses are limited by the lack of this information. Another variable that might interfere with both PA, mood and anxiety is fatigue (36,37). However, the relationships appear to be complex, especially between fatigue and depression, as fatigue might be a part of a depressive state as well as an isolated phenomenon.…”

Section: Study Limitationsmentioning

confidence: 99%

Relationship between pre-stroke physical activity and symptoms of post-stroke anxiety and depression: An observational study

Bovim¹,

Indredavik²,

Hokstad³

et al. 2019

J Rehabil Med

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Depression and anxiety are more common after stroke than in the general population. In non-stroke patients, physical activity and exercise is associated with less psychological distress. This study found that pre-stroke physical activity was associated with fewer depressive symptoms 3 months after stroke. However, being physically active was not related to symptoms of anxiety. In addition, most patients reported performing approximately the same level of physical activity before and after stroke. Despite the lack of causality, these findings indicate that pre-stroke physical activity might be protective against post-stroke depression, but not against anxiety. Objectives: To explore mechanisms affecting mental health in patients with stroke. The aims were to investigate the association between pre-stroke physical activity and symptoms of anxiety and depression 3 months after stroke, and to investigate how self-reported physical activity changed from before to 3 months after the stroke. Design: Secondary analyses of a prospective observational multicentre study. Patients: Stroke patients from 11 Norwegian stroke units. Methods: Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale, and physical activity was assessed by self-report. Negative binomial regression was used to analyse associations. Results: The analysed sample consisted of 205 patients; mean age was 74 years (standard deviation (SD) 11.5); 46% were women. Higher activity levels before stroke were associated with fewer symptoms of depression in multivariable analyses with regression coefficient of 0.84 (95% confidence interval 0.73-0.97), p = 0.015. Eighty-five (41.5%) patients reported similar activity levels before and after stroke. Conclusion: In this group of patients with mild symptoms of emotional distress, it seems that pre-stroke physical activity might be protective against poststroke depression, but not anxiety. Many patients with mild-to-moderate stroke report being equally active before and after the stroke.

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Post-stroke Fatigue and Depressive Symptoms Are Differentially Related to Mobility and Cognitive Performance

Cited by 50 publications

References 42 publications

Trajectories of fatigue among stroke patients from the acute phase to 18 months post-injury: A latent class analysis

Trajectories of fatigue among stroke patients from the acute phase to 18 months post-injury: A latent class analysis

Combined Cognitive-Motor Rehabilitation in Virtual Reality Improves Motor Outcomes in Chronic Stroke – A Pilot Study

Relationship between pre-stroke physical activity and symptoms of post-stroke anxiety and depression: An observational study

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