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A Journal on Physical Medicine and Rehabilitation after Pathological Events
Official Journal of the , , , ,
In association with
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Europa Medicophysica 2001 March;37(1):25-37
Influence of poststroke depression on functional outcome
Battaglia A., Bejor M.*
From the Department of Rehabilitation
Ospedale di Serravezza, ASL Viareggio (Lucca)
*IRCCS Policlinico S. Matteo, Pavia
Background. Considering the importance of epidemiological data regarding poststroke depression (PSD), we examined the influence of PSD on cognitive potential in stroke patients during the immediate post-acute phase and determined learning capacity in pathological conditions and, as a consequence, the efficacy of the rehabilitation program.
Methods. We investigated functional outcome in a consecutive series of patients with recent stroke. Patients were divided into two randomized PSD groups, one of which was treated with venlafaxine and another, the homogenous control group that was not treated with antidepressant drugs (during the period of study). All other medical and physiokinesological treatments were the same for both groups. The aim of the study was to determine whether there was a difference in outcome between the two groups and between patients in the treated group
Results. Comparison between the two groups of patients carried out with non parametric tests for continous discrete data, showed the changes in the treated group were significantly greater than those of the untreated group, in terms of the following: immediate reaction and multiple choice reaction times (IRT and MRT), ability to plan (FAS), abstract logic ability (GVA), word span (S), memory test (T) and Weigl test (W); there were no significant differences for the Corsi cube test (C), matrix test (M) and the scale of the depth of neuromotor lesion NIH. Outcome, evaluated using the Barthel Index, was significantly better in the treated group.
Conclusions. Other than confirming that the severity of the central lesion was not modified in relation to the treatment, and that rehabilitative therapy alone has a positive effect in modifying the degree of autonomy of the neurologically impaired patient, statistical analysis of the data also showed that the presence and entity of depression limits the level of functional outcome that can be reached. Antidepressant therapy makes a significant improvement in the performance of the cognitive sphere (especially regarding attention, times of multiple choice and abstract reasoning), and allows the patient to attain an improved outcome and a better degree of participation in his surroundings, a factor determining the quality of life after stroke. At a clinical level during the phase of intensive rehabilitation, it is important to pay attention to the diagnosis and timely treatment of depression, in order to help make therapeutic stimuli significant during rehabilitation.