Effects of aquatic exercise on depression and anxiety in ischemic stroke subjects

Abstract

Background: Stroke ranks third and is the leading cause of permanent disability in western countries. Furthermore there are no treatments for the psychosocial effects of this pathology. Purpose: Analyse the effect of an aquatic exercise program in depression and trace and state anxiety in subjects who suffered an ischemic stroke. Methods: Two groups were analyzed: experimental group (EG) n = 15, 50.3 ± 9.1 years; control group (CG) n = 13, 52.5 ± 7.7 years. EG underwent a 12-week aquatic exercise program. Both groups were evaluated in pre and post- treatment using Beck Depression Inventory (BDI) and Trace State Anxiety Inventory (IDATE). Wilcoxon signed-rank and Mann-Whitney tests were used to compare moments and groups, respec- tively. Results: The BDI scores of aquatic activities were: pre-treatment, 17.4 ± 7.7 and 16.9 ± 8.6 for the EG and CG, respectively; post-treat- ment, 13.2 + 7.1 and 16.4 + 7.9 for the EG and CG, respectively. The IDATE scores for anxiety trace in strength training were: pre-treatment, 43.2 + 12.5 and 42.9 + 12.2 for the EG and CG, respec- tively; post-treatment, 39.7 + 7.1 and 42.6 + 12.1 for the EG and CG, respectively. The IDATE scores for anxiety state in strength training were: pre-treatment, 46.9 + 7.6 and 47.4 + 8.1 for the EG and CG, respectively; post-treatment, 44.4 + 7.9 and 47.5 + 8.0 for the EG and CG, respectively. Significant differences were found in pre and post-treatment values in the EG and between groups in the depression and trace and state anxiety levels in post-treatment (p < 0.05). Conclusions: Aquatic physical activity contributes to an improvement of the levels of depression and anxiety in people who suffered a stroke.

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Aidar, F. , Garrido, N. , Silva, A. , Reis, V. , Marinho, D. and de Oliveira, R. (2013) Effects of aquatic exercise on depression and anxiety in ischemic stroke subjects. Health, 5, 222-228. doi: 10.4236/health.2013.52030.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Kjeldsen, S.E., Erdine, S., Farsang, C., Sleight, P. and Mancia, G. (2002) 1999 WHO/ISH Hypertension Guide lines—Highlights & ESH update. Journal of Hypertension, 20, 153-155. doi:10.1097/00004872-200201000-00022
[2] Frey, J.L., Jahnke, H.K. and Bulfinch, E.W. (1998) Dif ferences in stroke between white, hispanic, and native American patients: The barrow neurological institute stroke database. Stroke; A Journal of Cerebral Circulation, 29, 29-33. doi:10.1161/01.STR.29.1.29
[3] Haacke, C., Althaus, A., Spottke, A., Siebert, U., Back, T. and Dodel, R. (2006) Long-term outcome after stroke: Evaluating health-related quality of life using utility measurements. Stroke; A Journal of Cerebral Circulation, 37, 193-198. doi:10.1161/01.STR.0000196990.69412.fb
[4] Pittella, J.E.H. and Duarte, J.E. (2002) Prevalence and pattern of distribution of cerebrovascular diseases in 242 hospitalized elderly patients, in a general hospital, autop sied in Belo Horizonte, Minas Gerais, Brazil, from 1976 to 1997. Arquivos De Neuro-Psiquiatria, 60, 47-55. doi:10.1590/S0004-282X2002000100010
[5] Rezende, E.M., Sampaio, I.B.M. and Ishitani, L.H. (2004) Multiple causes of death due to non-communicable diseases: A multidimensional analysis. Cadernos De Saúde Pública/Ministério Da Saúde, Funda??o Oswaldo Cruz, Escola Nacional De Saúde Pública, 20, 1223-1231. doi:10.1590/S0102-311X2004000500016
[6] Aidar, F.J., Silva, A.J., Reis, V.M., Carneiro, A. and Carneiro-Cotta, S. (2007) A study on the quality of life in ischaemic vascular accidents and its relation to physical activity. Revista De Neurologia, 45, 518-522.
[7] Solenski, N.J. (2004) Transient ischemic attacks: Part I. Diagnosis and evaluation. American Family Physician, 69, 1665-1674.
[8] Esteve, M., Serra-Prat, M., Zaldívar, C., Verdaguer, A. and Berenguer, J. (2004) Impact of a clinical pathway for stroke patients. Gaceta Sanitaria/S.E.S.P.A.S, 18, 197-204.
[9] Maestre-Moreno, J.F. (2006) Stroke and resources for urgent neurological attention: Why arrive in time? Re vista De Neurologia, 42, 65-67.
[10] Morales-Ortiz, A., Amorín, M., Fages, E.M., et al. (2006) Use of extra-hospital emergency systems in the treatment of acute stroke in the region of Murcia. Possible repercussions on the urgent care of stroke patients. Revista De Neurologia, 42, 68-72.
[11] Chang, C.-F., Lin, S.-Z., Chiang, Y.-H., Morales, M., Chou, J., Lein, P., Chen, H.-L., Hoffer, B.J. and Wang, Y. (2003) Intravenous administration of bone morphogenetic protein-7 after ischemia improves motor function in stroke rats. Stroke; A Journal of Cerebral Circulation, 34, 558 564. doi:10.1161/01.STR.0000051507.64423.00
[12] Mokudai, T., Ayoub, I.A., Sakakibara, Y., Lee, E.J., Ogilvy, C.S. and Maynard, K.I. (2000) Delayed treatment with nicotinamide (Vitamin B(3)) improves neurological outcome and reduces infarct volume after transient focal cerebral ischemia in Wistar rats. Stroke; A Journal of Cerebral Circulation, 31, 1679-1685. doi:10.1161/01.STR.31.7.1679
[13] Chang, K.-C., Tseng, M.-C. and Tan, T.-Y. (2004) Pre hospital delay after acute stroke in Kaohsiung, Taiwan. Stroke; A Journal of Cerebral Circulation, 35, 700-704. doi:10.1161/01.STR.0000117236.90827.17
[14] Abboud, H., Labreuche, J., Plouin, F. and Amarenco, P. (2006) High blood pressure in early acute stroke: A sign of a poor outcome? Journal of Hypertension, 24, 381 386. doi:10.1097/01.hjh.0000200516.33194.e3
[15] Samsa, G.P. and Matchar, D.B. (2004) How strong is the relationship between functional status and quality of life among persons with stroke? Journal of Rehabilitation Research and Development, 41, 279-282. doi:10.1682/JRRD.2003.08.0117
[16] Clark, T.G., Murphy, M.F.G. and Rothwell, P.M. (2003) Long term risks of stroke, myocardial infarction, and vascular death in “low risk” patients with a non-recent transient ischaemic attack. Journal of Neurology, Neuro surgery, and Psychiatry, 74, 577-580. doi:10.1136/jnnp.74.5.577
[17] Moon, Y.-S., Kim, S.-J., Kim, H.-C., Won, M.-H. and Kim, D.-H. (2004) Correlates of quality of life after stroke. Journal of the Neurological Sciences, 224, 37-41. doi:10.1016/j.jns.2004.05.018
[18] Kimura, M., Robinson, R.G. and Kosier, J.T. (2000) Treatment of cognitive impairment after poststroke depression: A double-blind treatment trial. Stroke; A Journal of Cerebral Circulation, 31, 1482-1486. doi:10.1161/01.STR.31.7.1482
[19] Sarris, J., Moylan, S., Camfield, D.A., Pase, M.P., Mis choulon, D., Berk, M., Jacka, F.N. and Schweitzer, I. (2012) Complementary medicine, exercise, meditation, diet, and lifestyle modification for anxiety disorders: A review of current evidence. Evidence-Based Complementary and Alternative Medicine: eCAM, 809653.
[20] Smith, J.C. (2013) Effects of emotional exposure on state anxiety after acute exercise. Medicine and Science in Sports and Exercise, 45, 372-378. doi:10.1249/MSS.0b013e31826d5ce5
[21] Aidar, F.J., De Oliveira, R.J., Silva, A.J., De Matos, D.G., Mazini Filho, M.L., Hickner, R.C. and Machado Reis, V. (2012) The influence of resistance exercise training on the levels of anxiety in ischemic stroke. Stroke Research and Treatment, 298375.
[22] Aidar, F.J., De Oliveira, R.J., Silva, A.J., De Matos, D.G., Carneiro, A.L., Garrido, N., Hickner, R.C. and Reis, V.M. (2011) The influence of the level of physical activity and human development in the quality of life in survivors of stroke. Health and Quality of Life Outcomes, 9, 89. doi:10.1186/1477-7525-9-89
[23] Skidmore, E.R., Whyte, E.M., Holm, M.B., Becker, J.T., Butters, M.A., Dew, M.A., Munin, M.C. and Lenze, E.J. (2010) Cognitive and affective predictors of rehabilitation participation after stroke. Archives of Physical Medicine and Rehabilitation, 91, 203-207. doi:10.1016/j.apmr.2009.10.026
[24] De Haan, R., Limburg, M., Bossuyt, P., Van der Meulen, J. and Aaronson, N. (1995) The clinical meaning of Rankin “handicap” grades after stroke. Stroke; A Journal of Ce rebral Circulation, 26, 2027-2030. doi:10.1161/01.STR.26.11.2027
[25] Brazilian Society of Cerebrovascular Diseases (BSCD) (1999) Working group on cerebrovascular pathology of ABN. Rankin scale of disability changed and modified Barthel index. Newsletter, 6, 7-12.
[26] Beck, A.T., Ward, C.H., Mendelson, M., Mock, J. and Erbaugh, J. (1961) An inventory for measuring depres sion. Archives of General Psychiatry, 4, 561-571. doi:10.1161/01.STR.26.11.2027
[27] Gorenstein, C. and Andrade, L. (1998) Inventário de de press?o de beck: Propriedades psicométricas da vers?o em português. Revista de Psiquiatria Clínica, órg?o Ofi cial do Departamento e Instituto de Psiquiatria Fa culdade de Medicina—Universidade de S?o Paulo, 25, 245-250.
[28] Dunn, G., Sham, P. and Hand, D. (1993) Statistics and the nature of depression. Psychological Medicine, 23, 871 889. doi:10.1017/S0033291700026350
[29] Gotlib, I.H. (1984) Depression and general psychopa thology in university students. Journal of Abnormal Psychology, 93, 19-30. doi:10.1037/0021-843X.93.1.19
[30] Tanaka-Matsumi, J. and Kameoka, V.A. (1986) Reliabilities and concurrent validities of popular self-report measures of depression, anxiety, and social desirability. Journal of Consulting and Clinical Psychology, 54, 328-333. doi:10.1037/0022-006X.54.3.328
[31] Beck, A.T., Steer, R.A. and Carbin, M.G. (1988) Psycho metric properties of the beck depression inventory: Twenty five years of evaluation. Clinical Psychology Review, 8, 77-100. doi:10.1016/0272-7358(88)90050-5
[32] Spielberger, C.D. and Gorsuch, R.L. (1983) Manual for the State-trait anxiety inventory (form Y) (“self-evalua tion questionnaire”). Consulting Psychologists Press, Palo Alto.
[33] Biaggio, A. and Natalício, L. (1979) Tradu??o e adapta ??o do manual de psicologia aplicada IDATE, Rio de Ja neiro.
[34] Borg, G.A. (1982) Psychophysical bases of perceived exertion. Medicine and Science in Sports and Exercise, 14, 377-381. doi:10.1249/00005768-198205000-00012
[35] Douglas, V.C., Johnston, C.M., Elkins, J., Sidney, S., Gress, D.R. and Johnston, S.C. (2003) Head computed tomography findings predict short-term stroke risk after transient ischemic attack. Stroke; A Journal of Cerebral Circulation, 34, 2894-2898. doi:10.1161/01.STR.0000102900.74360.D9
[36] Flossmann, E. and Rothwell, P.M. (2003) Prognosis of vertebrobasilar transient ischaemic attack and minor stroke. Brain: A Journal of Neurology, 126, 1940-1954.
[37] Hardie, K., Hankey, G.J., Jamrozik, K., Broadhurst, R.J. and Anderson, C. (2004) Ten-year risk of first recurrent stroke and disability after first-ever stroke in the Perth community stroke study. Stroke; A Journal of Cerebral Circulation, 35, 731-735. doi:10.1161/01.STR.0000116183.50167.D9
[38] Hardie, K., Hankey, G.J., Jamrozik, K., Broadhurst, R.J. and Anderson, C. (2003) Ten-year survival after first-ever stroke in the perth community stroke study. Stroke; A Journal of Cerebral Circulation, 34, 1842-1846. doi:10.1161/01.STR.0000082382.42061.EE
[39] Hankey, G.J. (2005) Secondary prevention of recurrent stroke. Stroke; A Journal of Cerebral Circulation, 36, 218 221. doi:10.1161/01.STR.0000153048.87248.3b
[40] Streifler, J.Y., Eliasziw, M., Benavente, O.R., Alamowitch, S., Fox, A.J., Hachinski, V.C. and Barnett, H.J.M. (2002) Prognostic importance of leukoaraiosis in patients with symptomatic internal carotid artery stenosis. Stroke; A Jour nal of Cerebral Circulation, 33, 1651-1655. doi:10.1161/01.STR.0000018010.38749.08
[41] Sachdev, P.S., Brodaty, H., Valenzuela, M.J., Lorentz, L., Looi, J.C.L., Wen, W. and Zagami, A.S. (2004) The neuropsychological profile of vascular cognitive impair ment in stroke and TIA patients. Neurology, 62, 912-919. doi:10.1212/01.WNL.0000115108.65264.4B
[42] Hankey, G.J. (2003) Long-term outcome after ischaemic stroke/transient ischaemic attack. Cerebrovascular Dis eases (Basel, Switzerland), 16, 14-19. doi:10.1159/000069936
[43] Simis, S. and Nitrini, R. (2006) Cognitive improvement after treatment of depressive symptoms in the acute phase of stroke. Arquivos De Neuro-Psiquiatria, 64, 412-417. doi:10.1590/S0004-282X2006000300012
[44] Dalle Carbonare, L., Maggi, S., Noale, M., Giannini, S., Rozzini, R., Lo Cascio, V. and Crepaldi, G. (2009) Physical disability and depressive symptomatology in an elderly population: A complex relationship. The Italian Longitudinal Study on Aging (ILSA). The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 17, 144-154. doi:10.1097/JGP.0b013e31818af817
[45] Zatzick, D., Jurkovich, G.J., Rivara, F.P., Wang, J., Fan, M.-Y., Joesch, J. and Mackenzie, E. (2008) A national US study of posttraumatic stress disorder, depression, and work and functional outcomes after hospitalization for traumatic injury. Annals of Surgery, 248, 429-437.
[46] Siepman, T.A.M., Janssens, A.C.J.W., De Koning, I., Polman, C.H., Boringa, J.B. and Hintzen, R.Q. (2008) The role of disability and depression in cognitive functioning within 2 years after multiple sclerosis diagnosis. Journal of Neurology, 255, 910-916. doi:10.1007/s00415-008-0814-x
[47] Lee, Y. and Park, K. (2008) Does physical activity moderate the association between depressive symptoms and disability in older adults? International Journal of Geriatric Psychiatry, 23, 249-256. doi:10.1002/gps.1870
[48] Ding, Y., Li, J., Lai, Q., Rafols, J.A., Luan, X., Clark, J. and Diaz, F.G. (2004) Motor balance and coordination training enhances functional outcome in rat with transient middle cerebral artery occlusion. Neuroscience, 123, 667 674. doi:10.1016/j.neuroscience.2003.08.031
[49] Carod-Artal, F.J. (2006) Post-stroke depression (I). Epi demiology, diagnostic criteria and risk factors. Revista De Neurologia, 42, 169-175.
[50] Carod-Artal, F.J., Ferreira Coral, L., Trizotto, D.S. and Menezes Moreira, C. (2009) Poststroke depression: Prevalence and determinants in Brazilian stroke patients. Cere brovascular Diseases (Basel, Switzerland), 28, 157-165. doi:10.1159/000226114
[51] Sagen, U., Vik, T.G., Moum, T., M?rland, T., Finset, A. and Dammen, T. (2009) Screening for anxiety and de pression after stroke: Comparison of the hospital anxiety and depression scale and the Montgomery and Asberg depression rating scale. Journal of Psychosomatic Research, 67, 325-332. doi:10.1016/j.jpsychores.2009.03.007
[52] Cumming, T.B., Collier, J., Thrift, A.G. and Bernhardt, J. (2008) The effect of very early mobilisation after stroke on psychological well-being. Journal of Rehabilitation Medicine: Official Journal of the UEMS European Board of Physical and Rehabilitation Medicine, 40, 609-614. doi:10.2340/16501977-0226
[53] Fure, B. (2007) Depression, anxiety and other emotional symptoms after cerebral stroke. Tidsskrift for Den Norske L?geforening: Tidsskrift for Praktisk Medicin, Ny R?kke, 127, 1387-1389.
[54] Conn, V.S. (2010) Anxiety outcomes after physical activity interventions: Meta-analysis findings. Nursing Research, 59, 224-231. doi:10.1097/NNR.0b013e3181dbb2f8
[55] Subirats Bayego, E., Subirats Vila, G. and Soteras Martínez, I. (2012) Exercise prescription: Indications, dosage and side effects. Medicina Clínica, 138, 18-24. doi:10.1016/j.medcli.2010.12.008

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