Post Stroke Depression: Relationship with Upper Limb Recovery, Activity and Participation

Post stroke depression is a significant factor impending rehabilitation outcome after stroke, specifically in the areas of upper limb recovery, independence in activity level and social participation. Relationship of post stroke depression (PSD) with upper limb recovery, functional independence and participation is still controversial. To assess how depression post stroke is related to recovery of upper limb, activity level and social participation. Two groups—those with depression and those without—were formed from 120 stroke patients with recovery times ranging from two to 24 weeks. The level of depression present across the entire sample of stroke patients was assessed using the Beck Depression Inventory (BDI). The Fugl-Meyer Assessment Upper Extremity section (FMA-UE) was used to evaluate upper limb motor recovery. Social participation was evaluated using the participation component of the Stroke Impact Scale (SIS), and activity level was evaluated using the Functional Independence Measure (FIM). Prevalence of depression in this study is 26% which is similar to earlier studies. A negative non-significant correlation was found between BDI and FMA-UE (r = −.277, p = 0.131), FIM (r = −.176, p = 0.343) and the participation component of SIS (r = −.295, p = 0.107). Patients in depressed and non-depressed group had similar improvement in recovery of upper limb at 6th week (p = 0.102) and on follow up evaluation at 18th week (p = 0.111).There was a significant difference found in the activity level (p = 0.012) and social participation (p = 0.036) at 6th week between the groups but at follow up both the groups had similar improvement (p > 0.05). Post stroke depression does not influence upper limb recovery as both depressed and non-depressed group patients had similar improvements, whereas activity level and social participation differed in both the groups at sixth week. Presence of depression may affect activity and participation at early phase of stroke, but later on may not affect as gradually patients recover. As rehabilitation of stroke patients in the early stage plays an important role in the recovery of patients as a whole, early accurate diagnosis and treatment of post stroke depression is crucial for a better rehabilitation outcome.