The role of rehabilitation and vitamin D supplementation on motor and psychological outcomes in poststroke patients
Authors:
- Lilla BonannoLilla Bonanno
- Caterina FormicaCFCaterina Formica
- Francesca Antonia ArcadiFAFrancesca Antonia Arcadi
- Davide CardileDCDavide Cardile
- Vincenzo CiminoVCVincenzo Cimino
- Placido BramantiPBPlacido Bramanti
- Elisabetta MoriniEMElisabetta Morini
Open Access
- 12 November 2021
- journal article
- research article
- Published by Wolters Kluwer Health in Medicine
- Vol. 100 (45) , e27747
Abstract
Post-Stroke depression affects between 12% and 72% of patients who have suffered a stroke. The association between low serum levels of 25-hydroxyvitamin D (25(OH) D) and increased risk of depression is reported in both stroke and non-stroke patients. Similarly, high 25(OH) D levels might be associated with greater functional improvement during rehabilitation program. We wanted to investigate the effects of an intensive rehabilitation on poststroke outcomes. We wondered if the daily rehabilitation of motor and cognitive functions could also have an effect on mood and functional abilities in addition to or as an alternative to vitamin D supplementation. We conducted a 12-week, randomized trial, double blind, parallel, monocentric clinical trial of 40 patients undergoing intensive neuro-rehabilitation treatment at a specialized care facility for ischemic or hemorrhagic brain stroke. Participants were randomly assigned, in a 1:1 ratio, to 1 of 2 parallel groups: in the experimental group, 2000 IU/day of oral cholecalciferol was administered; in the control group patients were not taking vitamin D supplementation. Patients underwent a text evaluation to investigate psychological and motor outcomes. Significant intra-group difference in outcomes measures was found but not between control group and experimental group. In the vitamin D group, we highlighted significant differences between T0 and T1 in calcium (P < .001), vitamin D (P < .001), in Montgomery Aasberg Depression Rating Scale (P = .001), and in Functional Independent Measures (P < .001). In the health control group, we found a significant difference in calcium (P = .003), vitamin D (P < .001), Montgomery Aasberg Depression Rating Scale (P = 0.006), in general self-efficacy (P = .009), and in Functional Independent Measures (P < .001). Our results show that the beneficial effect on mood and functional recovery is mainly due to neurorehabilitation rather than vitamin D supplementation.Keywords
This publication has 44 references indexed in Scilit:
- Efficacy of Vitamin D Supplementation in Depression in Adults: A Systematic ReviewThe Journal of Clinical Endocrinology & Metabolism, 2014
- Serum 25-hydroxyvitamin D predicts the short-term outcomes of Chinese patients with acute ischaemic strokeClinical Science, 2013
- The influence of self-efficacy, pre-stroke depression and perceived social support on self-reported depressive symptoms during stroke rehabilitationNeuropsychological Rehabilitation, 2013
- Depression after Stroke and Risk of Mortality: A Systematic Review and Meta-AnalysisStroke Research and Treatment, 2013
- 25-Hydroxyvitamin D concentrations and risk of venous thromboembolism in the general population with 18 791 participantsJournal of Thrombosis and Haemostasis, 2012
- Vitamin D and calcium insufficiency-related chronic diseases: molecular and cellular pathophysiologyEuropean Journal of Clinical Nutrition, 2009
- Motor recovery after stroke: a systematic reviewThe Lancet Neurology, 2009
- Vitamin D and the occurrence of depression: causal association or circumstantial evidence?Nutrition Reviews, 2009
- The General Self-Efficacy Scale: Multicultural Validation StudiesThe Journal of Psychology, 2005
- Distribution of the Vitamin D receptor and 1α-hydroxylase in human brainJournal of Chemical Neuroanatomy, 2005