By Jeremy Appleton, ND, CNS

Healthnotes Newswire (May 25, 2006)—Of the 600,000 American men and women who experience a stroke each year, an estimated 10 to 27% experience major depression, according to the Agency for Healthcare Research and Quality. Exercise is known to help prevent stroke and is also known to improve symptoms of depression, and now a new study has shown that exercise may be the key to improving depression caused by a stroke.

“Physical and mental health after stroke are closely related,” said Dr. Sue-Min Lai of the Department of Preventive Medicine and Public Health at the University of Kansas, lead author on the study. “They should be considered together when planning a treatment program.”

Stroke is a type of cardiovascular disease that affects the arteries leading to and within the brain. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or ruptures. When that happens, affected portions of the brain cannot get the blood and oxygen they require, leading to brain damage.

Stroke can cause several types of disabilities: paralysis or problems controlling movement, sensory disturbances including pain, problems using or understanding language, problems with thinking and memory, and emotional disturbances, such as depression.

The new study examined 100 stroke survivors who were randomly assigned to an exercise group or to a usual care (nonexercise) group. The exercise program was a progressive, structured, three-month physical regimen to improve strength, balance, and endurance and to encourage more use of the affected extremities. The people exercised in their homes three times a week for a total of 36 sessions, supervised by a physical or occupational therapist.

Ninety-three people were evaluated immediately after the program, and 80 were assessed again six months later. In the nonexercise group, about 36% had symptoms of depression at three months, compared with only 14% in the exercise group. At nine months, 25% of the nonexercisers had significant depressive symptoms compared with just 7.5% of the exercisers.

Most strokes occur in people 65 years of age and over. In people who have suffered a stroke, major depression lasts an average of just under a year. In addition to those who experience major depression, 15 to 40% experience some symptoms of depression within two months following a stroke.

Most stroke rehabilitation programs do not currently integrate the physical and mental aspects of recovery. “Our research,” said Dr. Lai, “suggests that optimal recovery from stroke is achieved when exercise is combined with monitoring for and treatment of depression.” (J Am Geriatr Soc 2006;54:240–7)

Jeremy Appleton, ND, CNS, is a licensed naturopathic physician, certified nutrition specialist, and published author. Dr. Appleton was the Nutrition Department Chair at the National College of Naturopathic Medicine, has served on the faculty at Bastyr University of Natural Health Sciences, and is a former Healthnotes Senior Science Editor and a founding contributor to Healthnotes Newswire. He has worked extensively in scientific and regulatory affairs in the supplement industry and is now a consultant through his company Praxis Natural Products Consulting and Wellness Services.

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