Depression and dynamic balance recovery among stroke survivors: A preliminary investigation
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Department of Medical Rehabilitation, Faculty of Health Science and Technology College of Medicine, University of Nigeria, Enugu Campus, Nigeria
Ukachukwu Okoroafor Abaraogu   

Department of Medical Rehabilitation, Faculty of Health Science and Technology College of Medicine, University of Nigeria, Enugu Campus, 40006 Enugu, Nigeria. Tel.: +234 8063582105.
Submission date: 2016-02-09
Acceptance date: 2016-05-04
Online publication date: 2016-06-23
Publication date: 2019-12-19
Pol. Ann. Med. 2017;24(2):123–128
Studies have suggested that there could be a link between balance problems and anxiety and depression conditions, and that rehabilitation of the balance system could help. However, a direct link has not been established between post-stroke depression and functional recovery and balance.

The aim of this preliminary investigation was to investigate the occurrences of depression and to assess dynamic balance recovery status of stroke survivors as a foundational study for to a future large investigation to establish the relationship between depression and dynamic balance recovery.

Material and methods:
A convenient sample of 18 stroke survivors was recruited from stroke patients attending the outpatient adult neurology unit of the Physiotherapy Department, University of Nigeria Teaching Hospital in a cross-sectional design. The Patient Health Questionnaire-9 and the Dynamic Gait Index / Functional Gait Assessment score were used to collect data for depression and dynamic balance recovery respectively. Associations between depression and dynamic balance recovery were determined using Chi-Square analysis at a confidence level of 95%. Analysis was done using SPSS v. 20.

Results and discussion:
Result showed a high prevalence (55.60%) of post-stroke depression among stroke survivors. Majority of the survivors (88.90% of patients) had poor dynamic balance recovery.

There is a high prevalence of post-stroke depression among stroke survivors and they have poor dynamic balance. However, owing to small sample of participants in the present study, its premature to draw conclusion on the relationship between depression and dynamic balance recovery among stroke survivors from the result of this study.

Authors have no conflict of interest to declare.
Gryfe CI, Amies A, Ashley MJ. A longitudinal study of falls in an elderly population: I. Incidence and morbidity. Age Ageing. 1977;6(4):201–210.
Wild D, Nayak US, Isaacs B. Prognosis of falls in old people living at home. J Epidemiol Commun Health. 1981;35(3):200–204.
Baker SP, Harvey AH. Fall injuries in the elderly. Clin Geriatr Med. 1985;1(3):501–512.
Tinetti ME. Performance-oriented assessment of mobility in elderly patients. J Am Geriatr Soc. 1986;34(2):119–126.
Tinetti ME, Speechely M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319(26):1701–1707.
Nyberg L, Gustafson Y. Patient falls in stroke rehabilitation: a challenge to rehabilitation strategies. Stroke. 1995;26(5):838–842.
Yavuzer G, Eser F, Karakus D, Karaoglan B, Stam HJ. The effects of balance training on gait late after stroke: a randomized controlled trial. Clin Rehabil. 2006;20(11):960–969.
Robinson RG, Starkstein SE. Current research in affective disorders following stroke. J Neuropsychiatry Clin Neurosci. 1990;2(1):1–14.
Starkstein SE, Robinson RG. Neuropsychiatric aspects of cerebral vascular disorders. In: Yudoflky SC, Hales RE, eds. The American Psychiatric Textbook of Neuropsychiatry. Washington, DC: APA Press; 1992:449–472.
Keenan MA, Perry J, Jordan C. Factors affecting balance and ambulation following stroke. Clin Orthop Relat Res. 1984;182:165–171.
Srivastava A, Taly AB, Gupta A, Murali T. Post-stroke depression: prevalence and relationship with disability in chronic stroke survivors. Ann Indian Acad Neurol. 2010;13(2):123–127.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–616.
Paolucci S. Epidemiology and treatment of post-stroke depression. Neuropsychiatr Dis Treat. 2008;4(1):145–154.
Hayee MA, Akhtar N, Haque A, Rabbani MG. Depression after stroke-analysis of 297 stroke patients. Bangladesh Med Res Counc Bull. 2001;27(3):96–102.
Cassidy E, O'Connor R, O'Keane V. Prevalence of post-stroke depression in an Irish sample and its relationship with disability and outcome following inpatient rehabilitation. Disabil Rehabil. 2004;26(2):71–77.
Kong KH, Yang SY. Health-related quality of life among chronic stroke survivors attending a rehabilitation clinic. Singap Med J. 2006;47(3):213–218.
Paolucci S, Gandolfo C, Provinciali L, Torta R, Toso V. The Italian multicenter observational study on post-stroke depression (DESTRO). J Neurol. 2006;253(5):556–562.
House A, Dennis M, Mogridge L, Warlow C, Hawton K, Jones L. Mood disorders in the year after first stroke. Br J Psychiatry. 1991;158:83–92.
Burvill PW, Johnson GA, Jamrozik KD, Anderson CS, Stewart-Wynne EG, Chakera TMH. Prevalence of depression after stroke: the Perth Community Stroke Study. Br J Psychiatry. 1995;166:320–327.
Wrisley DM, Marchetti GF, Kuharsky DK, Whitney SL. Reliability, internal consistency, and validity of data obtained with the functional gait assessment. Phys Ther. 2004;84(10):906–918.
Herrmann N, Black SE, Lawrence J, Szekely C, Szalai JP. The Sunnybrook Stroke Study: a prospective study of depressive symptoms and functional outcome. Stroke. 1998;29(3):618–624.
Robinson RG, Starr LB, Kubos KL, Price TR. A two-year longitudinal study of post-stroke mood disorders: findings during the initial evaluation. Stroke. 1983;14(5):736–741.
Głodzik-Sobańska L, Słowik A, Borratyńska A, Szczudlik A. Depressive symptoms following ischemic stroke. Neurol Neurochir Pol. 2003;37(1):17–25 [in Polish].
Bohannon RW, Smith MB, Larkin PA. Relationship between independent sitting balance and side of hemiparesis. Phys Ther. 1986;66(6):944–945.
Heilman KM, Bowers D, Valenstein E, Watson RT. The right hemisphere: neuropsychological functions. J Neurosurg. 1986;64(5):693–704.
Horak FB, Shupert CL, Mirka A. Components of postural dyscontrol in the elderly: a review. Neurobiol Aging. 1989;10(6):727–738.
Studenski S, Duncan PW, Chandler J. Postural responses and effector factor in persons with unexplained falls: results and methodological issues. J Am Geriatr Soc. 1991;39(3):229–234.
Rode G, Tiliket C, Boisson D. Predominance of postural imbalance in left hemiparetic patients. Scand J Rehabil Med. 1997;29(1):11–16.
Lord SR, Menz HB. Visual contributions to postural stability in older adults. Gerontology. 2000;46(6):306–310.
Gauchard GC, Jeandel C, Perrin PP. Physical and sporting activities improve vestibular afferent usage and balance in elderly human subjects. Gerontology. 2001;47(5):263–270.
Shumway-Cook A, Woollacott MH. Motor Control: Theory and Practical Applications. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2001.
Ustinova KI, Chernikova LA, Ioffe ME, Sliva SS. Impairment of learning the voluntary control of posture in patients with cortical lesions of different locations: the cortical mechanisms of pose regulation. Neurosci Behav Physiol. 2001;31(3):259–267.
Chen IC, Cheng PT, Chen CL, Chen SC, Chung CY, Yeh TH. Effects of balance training on hemiplegic stroke patients. Chan Gung Med J. 2002;25(9):583–590.
Bonan IV, Colle FM, Guichard JP, et al. Reliance on visual information after stroke. Part I: Balance on dynamic posturography. Arch Phys Med Rehabil. 2004;85(2):268–273.
Kopytko D, Kowalski PM. Balance disorders in children after cranial–cerebral trauma with total damage to the vestibular apparatus. Pol Ann Med. 2014;21(2):139–142.
de Haart M, Geurts AC, Huidekoper SC, Fasotti L, van Limbeek J. Recovery of standing balance in post-acute stroke patients: a rehabilitation cohort study. Arch Phys Med Rehabil. 2004;85(6):886–895.
Kiebzak W, Kowalski IM, Domagalska M, et al. Assessment of visual perception in adolescents with a history of central coordination disorder in early life-15-year follow-up study. Arch Med Sci. 2012;8(5):879–885.