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

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.