Taylor-Piliae Ruth E, Morrison Helena W, Hsu Chiu-Hsieh Paul, Whitman Susan, Grandner Michael
College of Nursing, University of Arizona, Tucson, AZ 85721, USA.
College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
Evid Based Complement Alternat Med. 2021 Nov 2;2021:8600443. doi: 10.1155/2021/8600443. eCollection 2021.
Depression is prevalent among one-third to two-thirds of acute and chronic stroke survivors. Despite the availability of pharmacotherapies and/or psychotherapies, depression persists, even for 5-10 years after stroke, reflecting limited treatment responses and/or adherence to this conventional care. Mind-body interventions are commonly used among adults to ameliorate depressive symptoms. Thus, the feasibility of Tai Chi, alongside conventional care, to manage poststroke depression was investigated using a single-group pre-post intervention design. Recruitment and retention, intervention adherence, safety, acceptability, and fidelity were assessed. Symptoms of depression, anxiety, and stress were assessed using standardized questionnaires, objective sleep was assessed via a research-grade triaxial accelerometer, and blood samples were taken to measure oxidative stress, inflammatory markers, and a neurotrophic growth factor using commercially available kits per manufacturer's protocol. Pre-post intervention changes were assessed using paired -tests. We enrolled stroke survivors ( = 11, mean age = 69.7 ± 9.3) reporting depression symptoms. After the intervention, we observed significant reductions in symptoms of depression (-5.3 ± 5.9, =0.01), anxiety (-2.2 ± 2.4, =0.01), and stress (-4.6 ± 4.8, =0.01), along with better sleep efficiency (+1.8 ± 1.8, =0.01), less wakefulness after sleep onset (-9.3 ± 11.6, =0.04), and less time awake (-9.3 ± 11.6, =0.04). There was a 36% decrease in oxidative stress (=0.02), though no significant changes in the other biomarkers were found (all values >0.05). Tai Chi exercise is a feasible intervention that can be used alongside conventional care to manage poststroke depression, aid in reducing symptoms of anxiety and stress, and improve sleep.
三分之一至三分之二的急性和慢性中风幸存者中普遍存在抑郁症。尽管有药物治疗和/或心理治疗方法，但抑郁症仍然存在，甚至在中风后持续5至10年，这反映出治疗反应有限和/或对这种传统护理的依从性不佳。身心干预在成年人中常用于改善抑郁症状。因此，采用单组干预前后设计，研究了太极拳与传统护理相结合管理中风后抑郁症的可行性。评估了招募和保留情况、干预依从性、安全性、可接受性和保真度。使用标准化问卷评估抑郁、焦虑和压力症状，通过研究级三轴加速度计评估客观睡眠，并按照各制造商的方案使用市售试剂盒采集血样以测量氧化应激、炎症标志物和神经营养生长因子。使用配对t检验评估干预前后的变化。我们招募了报告有抑郁症状的中风幸存者（n = 11，平均年龄 = 69.7 ± 9.3）。干预后，我们观察到抑郁症状（-5.3 ± 5.9，p = 0.01）、焦虑症状（-2.2 ± 2.4，p = 0.01）和压力症状（-4.6 ± 4.8，p = 0.01）显著减轻，同时睡眠效率提高（+1.8 ± 1.8，p = 0.01），睡眠开始后的清醒时间减少（-9.3 ± 11.6，p = 0.04），清醒时间减少（-9.3 ± 11.6，p = 0.04）。氧化应激降低了36%（p = 0.02），但其他生物标志物未发现显著变化（所有p值>0.05）。太极拳运动是一种可行的干预措施，可与传统护理一起用于管理中风后抑郁症，有助于减轻焦虑和压力症状，并改善睡眠。
