Effect of Very Early Mobilisation on Symptoms of Depression and Anxiety Following Acute Stroke: A Randomised Controlled Trial

Abstract

Introduction: Depression and Anxiety are one of the most commonly experienced problems by stroke survivors. It affects the functional status and quality of life of stroke survivor. Early physical activity may reduce symptoms of depression and anxiety. Aim: To determine the effect of very early mobilisation coupled with standard care compared with the standard care alone on symptoms of depression and anxiety following acute stroke. Materials and Methods: Study design was parallel active controlled, randomised controlled trial from December 2013 to December 2015. The intervention group received very early mobilisation including out of bed activities such as sitting, standing upright, walking begun within 24 hours of stroke onset for 5-30 minutes (Determined by patient tolerance) at least twice a day, for seven days. All the participants received standard physiotherapy care for 45 minutes once a day. Symptoms of depression and anxiety were measured using the Hospital Anxiety and Depression (HAD) rating scale on admission, at discharge and at three months follow-up. The Mann-Whitney U-test was used to compare the HAD rating scale measures between groups and the p-value <0.05 was considered as significant. Results: A total of 105 individuals with acute stroke (62 male and 43 female) aged 30-81 years were recruited in the study. The intervention group (n=48) demonstrated a significant decrease in symptoms of anxiety and depression at discharge (p<0.05) and at three months follow-up (p<0.05) than the standard care group (n=47). Conclusion: Very early mobilisation may be potential treatment to prevent or reduce symptoms of depression and anxiety following acute stroke.

Keywords

• acute cerebrovascular accident
• early physical activity
• hospital anxiety and depression rating scale
• mood
• physiotherapy