Interventions for treating anxiety after stroke

Knapp, Peter; Burton, Cassandra; Holmes, John; Murray, Jenni; Gillespie, David; Lightbody, Catherine Elizabeth; Watkins, Caroline; Chun, Ho-Yan Yvonne; Lewis, Sharon R

doi:10.1002/14651858.cd008860.pub3

Cited by 78 publications

(62 citation statements)

References 46 publications

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“…After stroke, approximately 30% of patients experience depression and 20% anxiety (Hackett, Yapa, Parag, & Anderson, 2005;Knapp et al, 2017). Individuals with post-stroke depression have a worse functional outcome, slower recovery, and increased mortality (Bartoli et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

A comparative clinical study of the effectiveness of computer cognitive training in patients with post-stroke cognitive impairments without dementia

Semen¹,

Farrell²,

Mozheyko³

et al. 2018

Psych. Rus.

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Section: Discussionmentioning

confidence: 99%

A comparative clinical study of the effectiveness of computer cognitive training in patients with post-stroke cognitive impairments without dementia

Semen¹,

Farrell²,

Mozheyko³

et al. 2018

Psych. Rus.

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“…We searched electronically for RCTs on Medline (1946-18/8/17), Embase (1980-17/8/17), PsychInfo (1940-17/8/17), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (inception-16/10/17), the Cochrane Stroke Register (16/10/17), and the Cochrane Central Register of Controlled Trials (CENTRAL) (inception-16/10/17) using search strategies supplied by the trials search co-ordinator of the Cochrane Stroke Group ( Supplement B ). We reviewed the reference list of key systematic reviews to date to identify additional titles [6] , [7] . We contacted authors of eligible titles that were trial protocols, conference abstracts or trial register entries for published or unpublished primary data.…”

Section: Methodsmentioning

confidence: 99%

“…cognitive restructuring, problem solving [4] , [5] . Randomized controlled trials (RCTs) of anxiety intervention in stroke have not yielded any definitive evidence in a recent Cochrane review—only three trials (2 pharmacological, 1 relaxation CD) with 196 participants were included [6] . These had high risk of bias and were of small sample size.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of anxiety interventions in stroke and acquired brain injury: Efficacy and trial design

Chun

Newman

Whiteley

et al. 2018

Journal of Psychosomatic Research

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ObjectiveThere is little randomized controlled trial (RCT) evidence to guide treatment for anxiety after stroke. We systematically reviewed RCTs of anxiety interventions in acquired brain injury (ABI) conditions including stroke and traumatic brain injury (TBI) in order to summarize efficacy and key aspects of trial design to help guide future RCTs.MethodsWe searched the Cochrane trial register, Medline, Embase, PsychInfo and CINAHL systematically up to August 2017. Two independent reviewers systematically selected studies and extracted data. We summarized the effect size, key study characteristics and sources of potential bias in trial design.Results14 studies (12 stroke; one stroke & TBI; one TBI) with 928 participants were included. Meta-analysis of five psychotherapy comparisons favoured intervention over control (standardized mean difference (SMD): − 0.41 [− 0.79, − 0.03], I2 = 28%); Overall effect size of pharmacotherapy comparisons favoured intervention over control (SMD: − 2.12 [− 3.05, − 1.18], I2 = 89%). One comparison of mixed pharmacotherapy and psychotherapy favoured intervention over usual care (SMD: − 4.79 [− 5.87, − 3.71]). One comparison favoured forest therapy versus urban control (SMD: − 2.00 [− 2.59, − 1.41]). All positive studies carried high or unclear risk of bias. Sample sizes were small in all included studies.ConclusionsThere is low quality evidence to suggest that psychotherapy and pharmacotherapy may be effective interventions in the treatment of anxiety after stroke based on underpowered studies that carried high risk of bias. Large-scale well-designed definitive trials are needed to establish whether pharmacological or psychotherapy works. Our review highlighted key considerations for investigators wishing to design high quality trials to evaluate treatments for anxiety after stroke.

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“…We therefore did not include the most recent studies which may have introduced new outcome measures. Since 2015, there are three new Cochrane reviews which are relevant to our field: memory deficits after stroke (das Nair, Cogger, Worthington, & Lincoln, 2016), anxiety after stroke (Knapp et al, 2017) and aphasia after stroke (Brady, Kelly, Godwin, Enderby, & Campbell, 2016). The evidence has increased rapidly in the field of memory rehabilitation: in 2007 two trials including 18 participants were included in the review, while in the latest review 13 trials including 514 participants were taken into account.…”

Section: Limitationsmentioning

confidence: 99%

An overview of outcome measures used in neuropsychological rehabilitation research on adults with acquired brain injury

Heugten

Caldenhove

Crutsen

et al. 2019

Neuropsychological Rehabilitation

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Outcome measurement is the cornerstone of evidence-based health care including neuropsychological rehabilitation. A complicating factor for outcome measurement in neuropsychological rehabilitation is the enormous number of measures available and the lack of a standard set of outcome measures. As a first step towards such a set, we reviewed intervention evaluation studies of the last 20 years to get an overview of instruments used for measuring outcome. The instruments were divided into two main categories: neuropsychological tests (International Classification of Functioning (ICF) level of functions) and other instruments (all other ICF domains). We considered the most common cognitive domains: memory, attention, executive functions, neglect, perception, apraxia, language/communication and awareness. Instruments used most for measuring outcome were neuropsychological tests (n = 215) in the domains of working memory, reaction times, neglect and aphasia. In the second category (n = 166) the multi-domain instruments were most represented. Several steps can be taken to select a standard set of outcome measures for future use. Next to evaluation of quality and feasibility of the instruments, expert opinion and consensus procedures can be applied.

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Interventions for treating anxiety after stroke

Cited by 78 publications

References 46 publications

A comparative clinical study of the effectiveness of computer cognitive training in patients with post-stroke cognitive impairments without dementia

A comparative clinical study of the effectiveness of computer cognitive training in patients with post-stroke cognitive impairments without dementia

A systematic review of anxiety interventions in stroke and acquired brain injury: Efficacy and trial design

An overview of outcome measures used in neuropsychological rehabilitation research on adults with acquired brain injury

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