Depression and movement ability after strokes.
In the developed world, the reported number of strokes has been decreasing over the past decade. There has been a substantial improvement in awareness of the symptoms of stroke and the number of deaths due to strokes has decreased by a massive 37%. However this leaves a large group of stroke survivors who have to cope with the many after effects which could include cognitive problems, physical pain, incontinence, visual problems, fatigue, emotional and physical problems as well as depression. Fifty per cent of patients suffer with depression within a year of having a stroke. The depression may appear immediately but may not arise for a few months or even later. Various factors can contribute to or even cause the depression. Physical damage to the brain is one of the most obvious causes. When the brain can no longer function in certain areas patients can have difficulty controlling their emotions and there can be a change in personality. There can be a huge amount of frustration in not being able to communicate and in not having the physical capacity of before the stroke which leads to anger and depression. Patients are often in a state of shock and can have chronic pain which contributes to depression. A research group that carried out previous studies on the benefits of acupuncture as an integrated therapy to treat depression, post natal depression and obsessive compulsive disorder in combination with conventional antidepressants has turned its attention to depression in stroke survivors. This month the group publishes a paper on their investigation into the use of electroacupuncture cranial stimulation and body acupuncture to alleviate the symptoms of depression in stroke survivors. The patients in the trial were split into two groups. The treatment group were given antidepressants plus 12 sessions of dense cranial electroacupuncture plus body electroacupuncture. The control group were given antidepressants, sham dense cranial electroacupuncture plus body acupuncture 3 times a week for 4 weeks. Results were assessed using the Hamilton Depression Rating Scale as well as a movement ability scale. Results showed that the group receiving the dense cranial electroacupuncture had reduced symptoms of depression after week 1 and at the end of the study. Results also showed that the group that received only body acupuncture had a much greater improvement in mobility after four weeks of treatment than the dense cranial electroacupuncture group. In conclusion it appears that the dense cranial electroacupuncture is the more effective treatment for the associated depression but that the body acupuncture is the better treatment for patients with restricted mobility.