Relation of depressive symptoms to outcome of CI movement therapy after stroke.
Michelle M Haddad, Gitendra Uswatte, Edward Taub and 2 others
PMID 29265871WHAT IT FOUND
Depressive symptoms did not stop stroke patients from improving arm use after Constraint-Induced Movement Therapy.
Patients with clinically significant depression improved just as much as those without. Depression scores also dropped slightly, but the change was too small to be clinically meaningful.
Key findings
01Pre-treatment severity of depressive symptoms did not predict how much patients improved their real-world arm use after CIMT.
02Patients with clinically significant depressive symptoms improved their arm use by 2.1 points, which was similar to the 1.8 point improvement in patients without significant symptoms.
03Depression scores decreased significantly from pre- to post-treatment, but the authors state the magnitude of change was too small to be clinically meaningful.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This was a preliminary, retrospective study of only 40 participants. The study design is observational, so it cannot prove that CIMT causes changes in depression or that depression has no effect on motor outcomes. Both the depression measure (Zung) and the outcome measure (MAL) were self-reported, which could introduce bias, although the authors noted these scores were not correlated at baseline. The sample excluded patients with severe aphasia or major cognitive deficits, so results may not apply to those populations.
The easy way to misread this
Do not assume that CIMT is an effective treatment for post-stroke depression. While depression scores dropped statistically, the authors explicitly state the change was too small to be clinically meaningful. The primary finding is that depression does not hinder the motor benefits of CIMT, not that CIMT resolves depression.