Difficulties in post-stroke gait improvement caused by post-stroke depression.

BACKGROUND

Depression is a common problem impeding post-stroke rehabilitation. Up to 70% of patients show depression symptoms during the first twelve months after stroke onset. However, the depression and its effect on functional recovery can be difficult to diagnose. The purpose of this study was to use gait analysis as a tool to compare the recovery after stroke in patients with and without depression and to assess the impact of the initiation time of rehabilitation after stroke onset.

METHODS

One hundred and forty five consecutive patients after first ever stroke admitted for designed rehabilitation program within 2 to 31 months after stroke onset participated. All patients received 4 weeks treatment program included comprehensive rehabilitation consisted of multipurpose activities 5 days a week. These included individual and group exercises, physiotherapy, occupational therapy and gait training. Gait analysis with Kistler force plates was employed to assess gait pattern symmetry before and after the treatment. Gait symmetry was evaluated based on seven gait parameters. Regaining of gait pattern symmetry was assumed as a measure of rehabilitation outcome.

RESULTS

After rehabilitation program gait symmetry was regained in patients without depression. Gait asymmetry remained unchanged in patients diagnosed with depression. No major differences in outcome from rehabilitation were noted in regards to the initiation time of rehabilitation after the stroke onset.

CONCLUSIONS

Depression limits gait recovery after stroke. The time of initiation of rehabilitation after stroke onset does not limit the motor recovery after rehabilitation program.