中风后极早期活动对心理健康的影响。

The effect of very early mobilisation after stroke on psychological well-being.

作者信息

Cumming Toby B, Collier Janice, Thrift Amanda G, Bernhardt Julie

机构信息

Neurosciences Building, Heidelberg Repatriation Hospital, 300Waterdale Rd, Heidelberg Heights, Victoria 3081, Australia.

出版信息

J Rehabil Med. 2008 Aug;40(8):609-14. doi: 10.2340/16501977-0226.

DOI:10.2340/16501977-0226

PMID:19020693

Abstract

OBJECTIVE

The immobility common to patients after acute stroke has the potential to increase negative mood symptoms. We evaluated the effect of very early mobilization after stroke on levels of depression, anxiety and irritability.

DESIGN

AVERT is a randomized controlled trial; patients in the very early mobilization group receive mobilization earlier (within 24 h of stroke) and more frequently than patients in the standard care group.

PATIENTS

Seventy-one patients with confirmed stroke were included.

METHODS

Patients were assessed on the Irritability, Depression and Anxiety (IDA) scale at multiple time-points.

RESULTS

At 7 days, very early mobilization patients were less depressed (z=2.51, p=0.012) and marginally less anxious (z=1.79, p=0.073) than standard care patients (Mann-Whitney test). Classifying IDA scores as normal or depressed, and using backward stepwise multivariable logistic regression, very early mobilization was associated with a reduced likelihood of depression at 7 days (odds ratio 0.14, 95% confidence interval 0.03-0.61; p=0.009).

CONCLUSION

Very early mobilization may reduce depressive symptoms in stroke patients at 7 days post-stroke.

摘要

目的

急性中风后患者常见的活动受限有可能增加负面情绪症状。我们评估了中风后极早期活动对抑郁、焦虑和易怒水平的影响。

设计

AVERT是一项随机对照试验；极早期活动组的患者比标准护理组的患者更早（中风后24小时内）且更频繁地接受活动。

患者

纳入71例确诊中风患者。

方法

在多个时间点对患者进行易怒、抑郁和焦虑（IDA）量表评估。

结果

在第7天，与标准护理组患者相比，极早期活动组患者的抑郁程度更低（z=2.51，p=0.012），焦虑程度略低（z=1.79，p=0.073）（曼-惠特尼检验）。将IDA评分分为正常或抑郁，并使用向后逐步多变量逻辑回归分析，极早期活动与第7天抑郁可能性降低相关（比值比0.14，95%置信区间0.03-0.61；p=0.009）。