{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:27:45Z","timestamp":1789586865790,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,10,20]],"date-time":"2024-10-20T00:00:00Z","timestamp":1729382400000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Upper limb recovery after stroke tends to be slower and incomplete. Participation in motor rehabilitation and exercise adherence are crucial to improve motor recovery. However, post\u2010stroke depression (PSD) could impede active participation in exercises. Therefore, this study investigates the association between depression and exercise adherence among community\u2010dwelling stroke survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross\u2010sectional study was conducted among 215 stroke survivors undergoing motor rehabilitation between February 2021 and January 2023. Patient Health Questionnaire\u20109 (PHQ\u20109) and Stroke\u2010Specific Measure of Adherence to Home\u2010based Exercises (SS\u2010MAHE) were measured to assess depression symptoms and exercise adherence, respectively. Fugl\u2010Meyer Assessment\u2010Upper Extremity (FMA\u2010UE) was administered to identify the influence of impairment on these factors. Chi\u2010square and multinomial and binary logistic regression analyses were applied to determine the relationships between these measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using the Chi\u2010square test, the PHQ\u20109 was significantly associated with SS\u2010MAHE (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Logistic regression analysis revealed that patients with moderate depression had lower odds of exercise adherence (OR:0.69, 95%CI:0.56, 0.85, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) compared to those with no depression. Type of exercises such as movement\u2010based (OR:2.00, 95%CI:1.80, 2.24, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and task\u2010based exercises (OR:1.80, 95%CI:1.53, 2.13, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), had higher adherence odds compared to those not exercising. Severe impairment (FMA\u2010UE) was significantly associated with lower exercise adherence (OR:0.71, 95%CI:0.54, 0.94, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and an increased risk of minimal depression (RR:11.09, 95%CI:1.17, 105.04, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) compared to mild impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PSD significantly impacts exercise adherence, with moderate depression notably reducing adherence rates. Incorporating mental health support into stroke rehabilitation could improve exercise adherence and potentially enhance upper limb motor recovery outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.70133","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T06:34:19Z","timestamp":1729492459000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Association between depression and adherence to upper limb exercises among community\u2010dwelling stroke survivors: A cross\u2010sectional study"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4732-0728","authenticated-orcid":false,"given":"Alexander","family":"Gnanaprakasam","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Manipal College of Health Professions Manipal Academy of Higher Education Manipal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0828-6977","authenticated-orcid":false,"given":"John M.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Manipal College of Health Professions Manipal Academy of Higher Education Manipal India"},{"name":"Centre for Comprehensive Stroke Rehabilitation and Research Manipal Academy of Higher Education Manipal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajit Kumar","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Neurology Manipal Hospitals, Old Airport Road Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8744-9331","authenticated-orcid":false,"given":"Anagha Srikant","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology, Manipal College of Health Professions Manipal Academy of Higher Education Manipal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7513-0606","authenticated-orcid":false,"given":"Suruliraj","family":"Karthikbabu","sequence":"additional","affiliation":[{"name":"KMCH College of Physiotherapy, Dr NGP Research and Educational Trust The Tamil Nadu Dr. M.G.R. 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