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Article in The American journal of occupational therapy.: official publication of the American Occupational
Therapy Association January 2015
DOI: 10.5014/ajot.2015.012054 Source: PubMed
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Effectiveness of Interventions for Adults With
Psychological or Emotional Impairment After Stroke:
An Evidence-Based Review
Mary W. Hildebrand
MeSH TERMS This evidence-based review was conducted to evaluate the effectiveness of occupational therapy interventions
affective symptoms to prevent or mitigate the effects of psychological or emotional impairments after stroke. Thirty-nine journal
articles met the inclusion criteria. Six types of interventions were identified that addressed depression, anx-
anxiety
iety, or mental healthrelated quality of life: exercise or movement based, behavioral therapy and stroke
depression education, behavioral therapy only, stroke education only, care support and coordination, and community-
evaluation studies as topic based interventions that included occupational therapy. Evidence from well-conducted research supports
occupational therapy using problem-solving or motivational interviewing behavioral techniques to address depression. The
stroke evidence is inconclusive for using multicomponent exercise programs to combat depression after stroke
and for the use of stroke education and care support and coordination interventions to address poststroke
anxiety. One study provided support for an intensive multidisciplinary home program in improving de-
pression, anxiety, and health-related quality of life. The implications of the findings for practice, research,
and education are discussed.
Hildebrand, M. W. (2015). Effectiveness of interventions for adults with psychological or emotional impairment after stroke:
An evidence-based review. American Journal of Occupational Therapy, 69, 6901180050. http://dx.doi.org/10.5014/
ajot.2015.012054