The effects of sunlight exposure therapy on the improvement of depression and quality of life in post-stroke patients: A RCT study

Abstract

Previous studies have suggested that nearly 30% of the stroke victims present with signs of depression within the first 5 years of illness. Since post-stroke depression significantly affects the patient both physically and psychologically, the emotional disturbances impede the progress and effectiveness of rehabilitation. To utilize sunlight therapy in post-stroke patients in order to improve the depression and daily activity function. This study was a single-blind design randomized controlled intervention with sunlight exposure design. The population were stroke patients with tendency to depression. Exposed to sunlight for at least 30 min per day, at least 14 days of exposure duration of 4 weeks. A total of 46 patients were 23 patients in the experimental group and the control group. The research tools include: depression status (Taiwanese depression scale, TDS), physical activity function (Barthel Index), and cognitive status (MMSE). The CONSORT guideline was used in this study. After the data was analyzed with the generalized estimating equation (GEE), significant improvement was noted among the experimental ground in 2 nd post-test depression score, daily function in the first and second post-test Barthel Index score. There was no significant improvement in cognitive function. This study confirms that sunlight therapy improves the mental health of post-stroke patients with depressed mood. It also enhances daily activity and facilitates the recovery to a health state.

The effects of exposure to solar radiation on human health

“…The single-blind clinical trial tested the effect of sunlight therapy (exposure of sun-protected forearms or calves to sunlight on sunny days (at least 10,000 lx) in Taiwan for an accumulated minimum of 30 min/day for a total of 14 days in 4 weeks) on depression in participants who were at least 1 month post-stroke. Testing at 1 month after the completion of the intervention showed a significant reduction in the depression score in the group receiving the sunlight therapy compared to a control (usual treatment) group [ 256 ].…”

A Narrative Review on the Non-Pharmacologic Interventions in Post-Stroke Depression

“…Consistent sunlight exposure for at least 30 minutes per day for at least 14 days has been associated with improvement in the depression scores among Taiwanese patients. 97 Not only does it improve mood among PSD patients, but light therapy has also likewise been shown to ameliorate insomnia in the same subset of patients. 98 This is also very well tolerated with treatment-related adverse effects not significantly different from controls.…”

Disruptions of Circadian Rhythms and Thrombolytic Therapy During Ischemic Stroke Intervention

“…In the context of disrupted circadian rhythms, the use of naturalistic lighting optimizes light exposure similar to solar time, allowing for resynchronization of the internal biological clock to the natural light dark cycle ( West et al, 2019 ). Using 24 h naturalistic lighting in rehabilitation units post-stroke found that patients experienced improved sleep with decreased disturbances, improved cognitive function, and endocrine function ( Wang and Chen, 2020 ). Other studies using artificial sunlight exposure therapy during the day, with increasing morning blue-spectral illuminance peaking in the afternoon to imitate daylight for a minimum of 14 days of exposure in 4 weeks post stroke reported improved daily function through the Bartel Index and depressive test scores ( Durgan et al, 2017 ).…”

“…Matrix metalloproteinases (MMPs) involved in vascular matrix remodeling, specifically, MMP-2 and MMP-9 are upregulated after tPA administration in focal cerebral ischemia ( Wang and Chen, 2020 ); MMP-9 concentrations were reduced in tPA knock-out mice ( Rosenberg, 2002 ). Furthermore, neuroedema was reduced after intracerebral hemorrhage through MMP inhibitor administration ( Wang et al, 2003 ).…”