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Abstract

Importance: Strokes are a leading cause of disability. 35-50% of stroke survivors develop depression, which is the most common physiological impairment post-stroke and associated with less functional independence with activities of daily living (ADLs) (Ezema et al., 2019; Hildebrand, 2014; Wijeratne & Sales, 2021).

Objective: This systematized review addressed interventions within the scope of occupational therapy that are effective for reducing depressive symptoms for adults post-stroke.

Data sources: A medical librarian searched the databases Medline, PsycINFO, and CINAHL. Quantitative studies, systematic reviews, meta-analyses, and randomized controlled trials published in English within the last ten years were included.

Study selection and data collection: English-language articles published between 2014 and 2024 were included if they addressed post-stroke depression, if interventions were within the scope of occupational therapy, and if it they were a quantitative study, systematic review, or meta-analysis.

Findings: We identified six themes across 27 articles comprising level IA and IB evidence. Themes included psychosocial, exercise-based, art and music, VR-based, telehealth, and other supportive approaches including a risk factor program and mirror therapy. There was strong evidence supporting psychosocial, exercise-based, art and music, VR-based interventions, telehealth, and a risk factor program, whereas interventions focused on mirror therapy were supported by moderate evidence.

Conclusion and relevance: Findings from this study suggest that OTPs can use psychosocial, VR-based, exercise-based, art, music, telehealth, and risk factor program interventions routinely in clinical practice to address post-stroke depression in adults. Mirror therapy should be considered on a case-by-case basis.

What this study adds: This research highlights that a range of interventions within the scope of OT are effective for reducing symptoms of depression post-stroke, which is important for enhancing quality of life among stroke survivors.

References:

Ezema, C. I., Akusoba, P. C., Nweke, M. C., Uchewoke, C. U., Agono, J., & Usoro, G. (2019). Influence of post-stroke depression on functional independence in activities of daily living. Ethiopian Journal of Health Science, 29(1), 841-846. https://doi.org/10.4314/ejhs.v29i1.5

Hildebrand, M. (2014). Effectiveness of interventions for adults with psychological or emotional impairment after stroke: An evidence-based review. The American Journal of Occupational Therapy, 69(1), Article 6901180050. p1-p9. https://doi.org/10.5014/ajot.2015.012054

Wijeratne, T. & Sales, C. (2021). Understanding why post-stroke depression may be the norm rather than the exception: The anatomical and neuroinflammatory correlates of post-stroke depression. Journal of Clinical Medicine, 10(8),1674.

Publication Date

2024

Disciplines

Occupational Therapy

OT Interventions for Post-Stroke Depression: A Systematized Review

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