Depressive Symptoms Are Associated With Reduced Unsupervised Training Participation in Inpatients With Subacute Stroke: A Secondary Data Analysis Study

Objective: To investigate the association between depressive symptoms and time spent in unsupervised training among inpatients with subacute stroke. Design: This study was a secondary analysis of an unpublished dataset from 34 inpatients with subacute stroke (19 males; median age 65 [interquartile range, 55-75] years). Primary outcome was the median time spent in unsupervised training across three leg cycle sessions. Secondary outcomes included the Functional Independence Measure motor scores at discharge and the length of stay. Depressive symptoms were defined as the Japanese version of the Geriatric Depression Scale Short Form score of 7 or more. Results: Twelve participants (35.3%) had depressive symptoms. The median total time spent in unsupervised training was significantly lower in the group with depressive symptoms (367 [249-799] sec) than in the group without depressive symptoms (888 [579-901] sec), with a medium effect size (U = 57, p = 0.006, Cohen's r = 0.46). No significant differences were found in the secondary outcomes (p > 0.05). Conclusions: Depressive symptoms were associated with reduced participation in unsupervised training among inpatients after stroke. The findings highlight the importance of considering psychological factors in designing and implementing self-rehabilitation programs at the early stages of rehabilitation.