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

• Main Authors: Martina Reiten Bovim, Bent Indredavik, Anne Hokstad, Toby Cumming, Julie Bernhardt, Torunn Askim
• Format: Article
• Language: English
• Published: Foundation for Rehabilitation Information 2019-10-01
• Series: Journal of Rehabilitation Medicine
• Subjects: cerebrovascular disease; mental health; exercise; depression; physical activity
• Online Access: https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2610
• ISSN: 1650-1977; 1651-2081

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 post-stroke depression, but not anxiety. Many patients with mild-to-moderate stroke report being equally active before and after the stroke.