Is there a correlation between depressive symptoms and motor skills in post-stroke patients? / Existe correlação entre sintomas depressivos e habilidades motoras em pacientes pós-AVC?

ABSTRACT Deficits in motor skills and depressive symptoms are common effects observed after stroke, so it is necessary to understand how these variables interact with each other. Therefore, the aim of this study was to investigate the relationship between these two variables in post-ischemic stroke patients. We evaluated 135 patients with a mean age of 60 years (± 15). The Fugl-Meyer assessment of motor function was used to assess motor skills in the upper limbs, lower limbs, balance, and sensitivity and the Beck Depression Inventory was applied to evaluate depressive symptoms. To assess the relationship between both components, Spearman's correlation was performed. Depressive symptoms were negatively correlated with all variables of motor skills. This study suggests that higher motor skills in post-stroke patients may be associated with fewer depressive symptoms. Thus, a better understanding of how post-stroke symptoms are interrelated may improve patient treatment and care, contributing to a better quality of life.

RESUMO Déficits na habilidade motora e presença de sintomas depressivos são comuns em pacientes pós-AVC. Assim, é necessário compreender como estas variáveis interagem entre si. O objetivo deste trabalho foi verificar esta relação em pacientes pós-AVC isquêmico. Participaram 135 sujeitos, com idade média de 60 anos (± 15). Foi utilizado o protocolo de desempenho motor Fugl Meyer para verificar a habilidade motora dos membros superiores, inferiores, equilíbrio e sensibilidade e o Inventário de Depressão de Beck para verificar os sintomas depressivos. Foi realizada a análise de Spearman para verificar a relação entre os dois componentes. Os sintomas depressivos se correlacionaram negativamente com todas as variáveis da habilidade motora. Assim, a maior habilidade motora implicou em menores sintomas depressivos. Portanto, compreender como as sequelas pós-AVC se relacionam auxilia no melhor tratamento e atendimento ao paciente, contribuindo para melhorar sua qualidade de vida.

Preferred rehabilitation setting among stroke survivors in Nigeria and associated personal factors

Background: Incorporating patients' preferences in the care they receive is an important component of evidence-based practice and patient-centred care.Objective: This study assessed stroke patients' preferences regarding rehabilitation settings. Methods: A cross-sectional design was used to examine preferences of stroke patients receiving physiotherapy at three hospitals in Northern Nigeria. Personal factors and preferred rehabilitation setting data were obtained using the Modified Rankin Scale (to assess global disability) and a researcher-developed questionnaire. Associations between preferences and personal factors were explored using bivariate statistics.Results: Sixty stroke patients whose mean age was 53.6 ± 14.8 years participated in the study. Most of the participants (38.3%) preferred an outpatient setting, 19 (31.7%) preferred rehabilitation in their homes, 14 chose inpatient rehabilitation (23.3%), while 4 (6.7%) preferred the community. Age and source of finance were significantly associated with preferences. The majority (66.7%) of those aged ≥ 65 years expressed a preference for rehabilitation in the home or community (X2 = 6.80; p = 0.03). Similarly, most of the participants (53.3%) who depended on family finances preferred home- or community-based rehabilitation, while most of those who depended on employment income for finances preferred an outpatient rehabilitation setting (X2 = 16.80; p = 0.01).Conclusion: A preference for rehabilitation in outpatient facilities predominated followed by home-based rehabilitation, and preferences varied based on age and source of finance. These variations in preferences have implications for making rehabilitation decisions

Prevalence and predictors of post stroke depression among elderly stroke survivors / Prevalência e preditores de depressão pós-AVC em idosos sobreviventes de acidente vascular cerebral

ABSTRACT Objective To identify the prevalence of post stroke depression (PSD) and their socio-demographic and clinical predictors among elderly stroke survivors after hospital discharge to home. Methods In this cross-sectional study, 90 elderly stroke survivors were evaluated 14 days after hospital discharge with the following scales: National Institutes of Health Stroke Scale, Functional Independence Measure, and Geriatric Depression Scale – 15 items (GDS-15). PSD was defined as a score > 5 on GDS-15. After univariate analyses, a multivariate logistic regression model was built to identify independent predictors of PSD. Results Fourteen days after hospital discharge, 27.7% (95%CI 18.1 to 37.2) of elderly stroke survivors had PSD. Functional dependence was the only independent predictor of PSD (OR: 1.04 95%CI: 1.01 to 1.09; p = 0.02). Conclusion After stroke, depressive symptoms are common among elderly survivors. The degree of functional dependency is the main predictor of PSD among elderly stroke patients in Brazil.

RESUMO Objetivos Identificar a prevalência de depressão pós-AVC (DPAVC) e seus preditores sócio-demográficos e clínicos nos idosos sobreviventes do acidente vascular cerebral (AVC) após alta hospitalar para casa. Métodos Nesse estudo transversal, 90 idosos sobreviventes do AVC foram avaliados 14 dias após alta hospitalar com as escalas a seguir: National Institutes of Health Stroke Scale, Medida da Independência Funcional (MIF), Escala de Depressão Geriátrica – 15 itens (EDG-15). DPAVC foi definida como escore > 5 na EDG-15. Depois da análise univariada, a regressão logística multivariada foi construída para identificar os preditores independentes da DPAVC. Resultados Quatorze dias após a alta hospitalar, 27,7% (IC95% = 18,1–37,2) dos idosos sobreviventes do AVC tinham DPAVC. A dependência funcional foi o único preditor independente da DPAVC (OR: 1.04 95%CI: 1,01–1,09; p = 0.02). Conclusão Após um AVC, sintomas depressivos são frequentes entre os idosos sobreviventes. O grau de dependência funcional é o principal preditor da DPAVC neste pacientes no Brasil.