Physical inactivity, depression and anxiety in acute stroke

Background: Physical inactivity and low mood are both common early after stroke, but it is unclear whether they are related. If they are found to be associated, this will have important implications for acute stroke care. Methods: We measured physical activity, using the Position Activity Logger (PAL2) electronic device, and psychological wellbeing, using the Irritability, Depression and Anxiety (IDA) scale, within 14 days of stroke. Findings: Patients were very inactive, spending a median of 96% of the day either sitting or lying down. Depressive symptoms were exhibited by 74% of patients, and anxiety symptoms were exhibited by 53% of patients. While depressive symptoms were not related to physical activity, there was some indication that patients with anxiety symptoms spent more of the day lying down and less of the day sitting, standing or walking than those without anxiety symptoms (P=0.06). Having a previous history of depression was strongly associated with mood problems in acute stroke. Conclusions: Understanding the relationship between physical activity and mood after stroke is important. It is possible that stroke patients with anxiety symptoms are reluctant to engage in out-of-bed activities in the acute stage.