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Football as Medicine against cardiovascular disease
Published in Peter Krustrup, Daniel Parnell, Football as Medicine, 2019
Magni Mohr, Peter Riis Hansen, Felipe Lobelo, Lars Nybo, Zoran Milanović, Peter Krustrup
Cerebrovascular disease, including stroke, transient ischemic attack and cerebral bleeding, is clinically defined as a rapid onset disorder of brain function with symptoms lasting more than 24 hours or causing death. The cause is likely to be of vascular origin. Average age of the patients is 75 years, however 20% are younger than 65 years. Parts of brain functions deteriorate, and symptomatic stroke patients mainly have unilateral paresis of extremities. In addition, about one third also experience aphasia. Some stroke patients may also display cognitive and emotional impairment, and around 30% experience post-stroke depression (Paolucci et al. 2006). Patients with prior stroke are therefore likely to be physically inactive (Rand et al. 2009). Physical inactivity is a major cause for atherosclerotic disease and hypertension, which is supported by epidemiological findings demonstrating that physical inactivity is a predictor of apoplexy (Hu et al. 2007; Krarup et al. 2007; Krarup et al. 2008; Sui, LaMonte, and Blair 2007; Boysen and Krarup 2009). In contrast, stroke patients who have a high physical activity level display comparatively fewer severe subsequent strokes and show superior recovery results compared to their inactive counterparts (Krarup et al. 2008).
Differences in C-Reactive Protein (CRP) between depression levels in ischaemic stroke patients
Published in Cut Adeya Adella, Stem Cell Oncology, 2018
S.N. Lubis, W.H. Lubis, I. Nasution
Post-Stroke Depression (PSD) is one of the most common stroke complications, characterised by mood abnormalities, self-blame, and sadness; it is diagnosed in 40-72% of stroke patients. PSD is a major factor that can inhibit the healing function of neurologic stroke patients and increase mortality. Depression will affect patient behaviours, such as medical rehabilitation, smoking, diet, medication adherence, and physical activity. Depression also affects physiological factors such as autonomic nervous system disorders and inflammation (Solnek & Seiter, 2002; Schuyler, 2000).
Cognitive Behavioural Therapy for People with Brain Injury
Published in Barbara A. Wilson, Jill Winegardner, Caroline M. van Heugten, Tamara Ownsworth, Neuropsychological Rehabilitation, 2017
Tamara Ownsworth, Fergus Gracey
The evidence supporting CBT interventions for post-stroke depression is also largely mixed. A Cochrane review by Hackett and colleagues (2008b) found insufficient evidence to support the efficacy of CBT interventions for treating people with a depression diagnosis or clinically elevated symptoms. However, a Cochrane review by Hackett et al. (2008a) on interventions for preventing post-stroke depression found small but significant effects, which were mainly due to the positive findings of two large intervention studies (n=411–450). Specifically, House (2000) found significant effects of a brief problem-solving intervention (median of five sessions) on mood symptoms relative to standard care and attention control groups. Watkins et al. (2007) reported significant benefits of four weekly sessions of motivational interviewing, with intervention participants more likely to exhibit normal mood (49 per cent) compared to those receiving usual care (39 per cent).
Commentary. Freud in the stroke ward: psychodynamic theory for stroke rehabilitation professionals
Published in Topics in Stroke Rehabilitation, 2023
Before any form of therapy can take place – be it neurorehabilitative therapy or psychotherapy – it has to be possible for the therapist to bear without fear the feelings that the therapy will entail. Some such feelings are best regarded as signs of something having gone awry. In the context of stroke, persistent low mood can be a sign of a serious depression that requires medical intervention. These feelings are not just borne, but treated. But even accounting for the estimated 30% prevalence of post stroke depression, many patients experiencing strong negative emotions after a stroke don’t necessarily rise to the threshold of having a disorder that can be treated with a psychiatric medication. It is the job of stroke therapists to offer support in the context of this emotional climate.
Factors associated with mental health service access among Australian community-dwelling survivors of stroke
Published in Disability and Rehabilitation, 2023
Priscilla Tjokrowijoto, Renerus J. Stolwyk, David Ung, Monique F. Kilkenny, Joosup Kim, Lachlan L. Dalli, Dominique A. Cadilhac, Nadine E. Andrew
Forty percent of participants self-reported anxiety/depression during the AuSCR follow-up at 3–6 months post-stoke, and 26% reported receiving a medical diagnosis of depression/anxiety within approximately 2.5 years post-stroke. These data are consistent with previous studies which report that around one third of people living with stroke experience depression and/or anxiety at some point following their stroke [2,4]. Among participants who self-reported a diagnosis of depression/anxiety, seventy percent were not accessing mental health services. This is similar to the proportion of Australians with stroke living in the community who reported unmet psychological needs as part of a national survey [14]. Unmitigated depression/anxiety may affect a range of post-stroke outcomes, including mortality, efficiency of rehabilitation, activity limitations, and quality of life [32–37]. People living with stroke who do not suffer from depression or who receive treatment for their depression experience higher functional improvement at the end of rehabilitation [38]. This suggests that the effect of post-stroke depression on functional recovery may be ameliorated with appropriate treatment. A combination of psychotherapy and pharmacotherapy is the currently recommended approach for treating post-stroke depression [12]. Clinical guidelines for the treatment and prevention of post-stroke mood disturbances include antidepressant medication, exercise programs, and psychological therapies [39].
“For them and for me”: a qualitative exploration of peer befrienders’ experiences supporting people with aphasia in the SUPERB feasibility trial
Published in Disability and Rehabilitation, 2022
S. Northcott, N. Behn, K. Monnelly, B. Moss, J. Marshall, S. Thomas, A. Simpson, S. McVicker, C. Flood, K. Goldsmith, K. Hilari
Stroke is a leading cause of permanent disability in adults [1]. Having a stroke disrupts a person’s assumptions about themselves and their life. The process of adapting and coping with this “changed self” can be painful and challenge a person’s psychosocial wellbeing [2]. Prevalence of post-stroke depression is 29% up to 10 years after stroke, with the cumulative incidence within five years of stroke being between 39 and 52% [3]. Anxiety is also common, estimated at 29.3% during the first year [4]. Around one-third of strokes result in aphasia, a communication disability than can affect speaking, understanding, reading, and writing [5]. People with aphasia are at higher risk of depression [6] and reduced social networks [7,8] than stroke survivors without aphasia. It is therefore concerning that people with aphasia are often excluded from stroke mental health research due to their language disability [9] and have reported difficulty in accessing mental health services [10,11]. There is currently limited evidence for effective psychological interventions for this group, particularly interventions aimed at preventing people from developing depression as they adjust to living with the stroke and aphasia [12]. One potential intervention is peer-befriending, which may benefit the wellbeing of both befriender and befriendee [13–15]. The current paper investigates the experiences of people with post-stroke aphasia working as peer-befrienders.