Skip to main content
SpringerLink
Log in

Possibilities for Correcting Emotional and Behavioral Impairments in Stroke Patients during Rehabilitation Therapy

  • Published:
Neuroscience and Behavioral Physiology Aims and scope Submit manuscript

Objectives. To assess the efficacy of a set of rehabilitation measures including use of mechanotherapy and cognitive stimulation using tablet PC technology in relation to emotional and behavioral impairments in patients during the acute phase of ischemic stroke. Materials and methods. The study included 100 patients with ischemic stroke admitted to hospital in the acute period. All patients were randomized to two groups: a study group and a control group. The study group (50 patients) received daily robot mechanotherapy using a MOTOmed bedside trainer and tablet PC technology for independent exercises for patients to develop memory, perception, reactions, and counting. Patients of the control group (50 patients) received standard therapy. Functional status was assessed using the modifi ed Rankin scale. Objective evaluation of emotional and behavioral impairments was obtained using psychometric scales (Beck Depression and Anxiety Scales). Results. Use of complex rehabilitation programs in the acute period of ischemic stroke promoted regression of emotional and behavioral impairments (p = 0.0001). The severity of depressive disorders was decreased in patients of the study group by the end of the in-patient period, and further regression in these patients continued throughout the observation period, to the six-month point (p = 0.001). Measures of anxiety showed statistically significant decreases during the whole of the observation period in patients of the study group (p = 0.0001), in contrast to those of the control group, where no changes were seen. Functional recovery was better in patients of the study group, as evidenced by statistically significant changes in mean measures of changes on the Rankin scale. Conclusions. The rehabilitation program presented here, including mechanotherapy and cognitive stimulation using tablet PC technology, is a simple and accessible method for correcting emotional and behavioral impairments in patients in the acute period of ischemic stroke. The results achieved not only persisted over time, but were followed by further improvements in measures at three and six months.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. L. Ayerbe, S. Ayis, C. D. A. Wolfe, and A. G. Rudd, “Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis,” Brit. J. Psychiatry, 202, No. 1, 14–21 (2013), https://doi.org/10.1192/bjp.bp.111.107664.

    Article  Google Scholar 

  2. M. A. Kutlubaev and M. L. Hackett, “Part II: predictors of depression after stroke and impact of depression on stroke outcome: an updated systematic review of observational studies,” Int. J. Stroke, 9, No. 8, 1026–1036 (2014), https://doi.org/10.1111/ijs.12356.

    Article  Google Scholar 

  3. T. Kwok, R. S. Lo, E. Wong, et al., “Quality of life of stroke survivors: a 1-year follow-up study,” Arch. Phys. Med. Rehabil., 87, No. 9, 1177–1182 (2006), https://doi.org/10.1016/j.apmr.2006.05.015.

    Article  Google Scholar 

  4. R. G. Robinson and R. E. Jorge, “Post-stroke depression: a review,” Am. J. Psychiatry, 173, No. 3, 221–231 (2016), https://doi.org/10.1176/appi.ajp.2015.15030363.

    Article  Google Scholar 

  5. K. Salter, J. A. McClure, H. Mahon, et al., “Adherence to Canadian best practice recommendations for stroke care: assessment and management of poststroke depression in an Ontario rehabilitation facility,” Top. Stroke Rehabil., 19, No. 2, 132–140 (2012), https://doi.org/10.1310/tsr1902-132.

    Article  Google Scholar 

  6. M. P. Lindsay, M. Bayley, M. D. Hill, et al., Canadian Stroke Best Practice Recommendations, Heart and Stroke Foundation, Ottawa, Ontario, Canada (2014).

    Google Scholar 

  7. M. Flaster, A. Sharma, and M. Rao, “Poststroke depression: a review emphasizing the role of prophylactic treatment and synergy with treatment for motor recovery,” Top. Stroke Rehabil., 20, No. 2, 139–150 (2013), https://doi.org/10.1310/tsr2002-139.

    Article  Google Scholar 

  8. S. E. Kouwenhoven, M. Kirkevold, K. Engedal, and H. S. Kim, “Depression in acute stroke: prevalence, dominant symptoms and associated factors. A systematic literature review,” Disabil. Rehabil., 33, No. 7, 539–556 (2011), https://doi.org/10.3109/09638288.2010.505997.

    Article  Google Scholar 

  9. M. L. Hackett, C. Yapa, V. Parag, and C. S. Anderson, “Frequency of depression after stroke: a systematic review of observational studies,” Stroke, 36, No. 6, 1330–1340 (2005), https://doi.org/10.1161/01.STR.0000165928.19135.35.

    Article  Google Scholar 

  10. L. A. Babkair, “Risk factors for poststroke depression: An integrative review,” J. Neurosci. Nurs., 49, No. 2, 73–84 (2017), https://doi.org/10.1097/JNN.0000000000000271.

    Article  Google Scholar 

  11. M. L. Hackett and K. Pickles, “Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies,” Int. J. Stroke, 9, No. 8, 1017–1025 (2014), https://doi.org/10.1111/ijs.12357.

    Article  Google Scholar 

  12. H. Dam, “Depression in stroke patients 7 years following stroke,” Acta Psychiatr. Scand., 103, No. 4, 287–293 (2001), https://doi.org/10.1034/j.1600-0447.2001.103004287.x.

    Article  CAS  Google Scholar 

  13. C. A. Campbell Burton, J. Murray, J. Holmes, et al., “Frequency of anxiety after stroke: a systematic review and meta-analysis of observational studies,” Int. J. Stroke, 8, No. 7, 545–559 (2013), https://doi.org/10.1111/j.1747-4949.2012.00906.x.

    Article  Google Scholar 

  14. H. Y. Chun, W. N. Whiteley, M. S. Dennis, et al., “Anxiety after stroke: The importance of subtyping,” Stroke, 49, No. 3, 556–564 (2018), https://doi.org/10.1161/STROKEAHA.117.020078.

    Article  Google Scholar 

  15. J. H. White, J. Attia, J. Sturm, et al., “Predictors of depression and anxiety in community dwelling stroke survivors: a cohort study,” Disabil. Rehabil., 36, No. 23, 1975–1982 (2014), https://doi.org/10.3109/09638288.2014.884172.

    Article  Google Scholar 

  16. A. De Ryck, R. Brouns, M. Geurden, et al., “Risk factors for poststroke depression: identifi cation of inconsistencies based on a systematic review,” J. Geriatr. Psychiatry Neurol., 27, No. 3, 147–158 (2014), https://doi.org/10.1177/0891988714527514.

    Article  Google Scholar 

  17. V. Guiraud, T. Gallarda, D. Calvet, et al., “Depression predictors within six months of ischemic stroke: The DEPRESS Study,” Int. J. Stroke, 11, No. 5, 519–525 (2016), https://doi.org/10.1177/1747493016632257.

    Article  Google Scholar 

  18. I. L. Katzan, N. R. Thompson, K. Uchino, and B. Lapin, “The most affected health domains after ischemic stroke,” Neurology, 90, No. 16, 1364–1371 (2018), https://doi.org/10.1212/WNL.0000000000005327.

    Article  Google Scholar 

  19. R. G. Robinson and R. E. Jorge, “Post-stroke depression: a review,” Am. J. Psychiatry, 173, No. 3, 221–231 (2016), https://doi.org/10.1176/appi.ajp.2015.15030363.

    Article  Google Scholar 

  20. A. Nickel and G. Thomalla, “Post-stroke depression: Impact of lesion location and methodological limitations – A topical review,” Front. Neurol., 8, 498 (2017), https://doi.org/10.3389/fneur.2017.00498.

    Article  Google Scholar 

  21. Y. Zhang, H. Zhao, Y. Fang, et al., “The association between lesion location, sex and poststroke depression: Meta-analysis,” Brain Behav., 7, No. 10, e00788 (2017), https://doi.org/10.1002/brb3.788.

    Article  Google Scholar 

  22. N. Wei, W. Yong, X. Li, et al., “Post-stroke depression and lesion location: a systematic review,” J. Neurol., 262, No. 1, 81–90 (2015), https://doi.org/10.1007/s00415-014-7534-1.

    Article  Google Scholar 

  23. H. Ihle-Hansen, B. Thommessen, M. W. Fagerland, et al., “Effect on anxiety and depression of a multifactorial risk factor intervention program after stroke and TIA: a randomized controlled trial,” Aging Ment. Health, 18, No. 5, 540–546 (2014), https://doi.org/10.1080/13607863.2013.824406.

    Article  Google Scholar 

  24. S. B. Wang, Y. Y. Wang, Q. E. Zhang, et al., “Cognitive behavioral therapy for post-stroke depression: A meta-analysis,” J. Affect. Disord., 235, 589–596 (2018), https://doi.org/10.1016/j.jad.2018.04.011.

    Article  CAS  Google Scholar 

  25. S. K. Simblett, M. Yates, A. P. Wagner, et al., “Computerized cognitive behavioral therapy to treat emotional distress after stroke: A feasibility randomized controlled trial,” JMIR Ment. Health, 4, No. 2, e16 (2017), https://doi.org/10.2196/mental.6022.

    Article  Google Scholar 

  26. R. De Luca, M. Torrisi, A. Piccolo, et al., “Improving post-stroke cognitive and behavioral abnormalities by using virtual reality: A case report on a novel use of nirvana,” Appl. Neuropsychol. Adult, 25, No. 6, 581–585 (2018), https://doi.org/10.1080/23279095.2017.1338571.

    Article  Google Scholar 

  27. V. I. Sheregeshev, Yu. V. Plyasova, S. V. Kotov, et al., “Optimization of rehabilitation procedure in a patient with acute stroke based on mechanotherapy and cognitive stimulation with the use of tablet PC technology,” Al’manakh Klin. Med., 44, No. 3, 369–375 (2016), www.monikiweb.ru, https://doi.org/10.18786/2072-0505-2016-44-3-369-375.

    Article  Google Scholar 

  28. E. Lattari, H. Budde, F. Paes, Neto GAM, et al., “Effects of aerobic exercise on anxiety symptoms and cortical activity in patients with panic disorder: A pilot study,” Clin. Pract. Epidemiol. Ment. Health, 14, 11–25 (2018), https://doi.org/10.2174/1745017901814010011.

    Article  Google Scholar 

  29. M. Moriya, C. Aoki, and K. Sakatani, “Effects of physical exercise on working memory and prefrontal cortex function in post-stroke patients,” Adv. Exp. Med. Biol.,;923:203–208 (2016), https://doi.org/10.1007/978-3-319-38810-6_27.

    Article  CAS  Google Scholar 

  30. A. Jorm, “The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): a review,” Int. Psychogeriatr., 16, No. 3, 1–19 (2004).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Vladimirskii Moscow Regional Research Clinical Institute, Moscow, Russia

    S. V. Kotov, E. V. Isakova & V. I. Sheregeshev

Authors
  1. S. V. Kotov
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. V. Isakova
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. V. I. Sheregeshev
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. V. Kotov.

Additional information

Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 119, No. 4, Iss. 1, pp. 26–31, April, 2019.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kotov, S.V., Isakova, E.V. & Sheregeshev, V.I. Possibilities for Correcting Emotional and Behavioral Impairments in Stroke Patients during Rehabilitation Therapy. Neurosci Behav Physi 50, 156–161 (2020). https://doi.org/10.1007/s11055-019-00882-1

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11055-019-00882-1

Keywords

Search

Navigation