PTOTCohortArchives of physical medicine and rehabilitation2023

Rest-Activity Rhythm Characteristics Associated With Depression Symptoms in Stroke Survivors.

Sarah T Stahl, Elizabeth Skidmore, Emily Kringle and 7 others

PMID 36736806

WHAT IT FOUND

Stroke survivors with more fragmented 24-hour activity patterns had higher odds of depression symptoms.

This association held across two distinct samples. The link was strongest for clinically significant depression rather than mild symptoms.

Key findings

01Greater intra-daily variability, indicating more fragmented 24-hour patterns, was associated with statistically higher odds of depression symptoms in both the local and national samples.

02In the national sample, greater fragmentation was associated with higher odds of clinically significant depression but not mild depression symptoms.

03Other activity pattern characteristics, such as timing, stability, or strength, were not statistically associated with the likelihood of having depression symptoms.

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

The study is cross-sectional, so it cannot determine if fragmented activity causes depression or if depression causes fragmented activity. The local sample excluded individuals with severe aphasia, major depressive disorder, and those currently in rehab, limiting generalizability to more impaired populations. The two samples used different devices placed on different body parts (thigh vs. wrist), which could affect the absolute values of activity data, though the analysis focused on scale-independent measures. The study did not measure potential confounders like sleep architecture, insomnia, or napping, which could contribute to the observed fragmentation.

Declared interests

One author is the owner and CEO of a company developing activity pattern monitoring technology, though the paper states this author was not involved in the work reported here. The study was supported by NIH awards.

The easy way to misread this

Do not assume that treating the fragmented activity pattern will reduce depression. The study is cross-sectional and cannot prove that the fragmentation causes the depression or that changing the rhythm would improve the mood.

Read it on PubMed →