Objective: To investigate the association between depressive symptoms and time spent in unsupervised training among inpatients with subacute stroke. Design: This study was a secondary analysis of an unpublished dataset from 34 inpatients with subacute stroke (19 males; median age 65 [interquartile range, 55-75] years). Primary outcome was the median time spent in unsupervised training across three leg cycle sessions. Secondary outcomes included the Functional Independence Measure motor scores at discharge and the length of stay. Depressive symptoms were defined as the Japanese version of the Geriatric Depression Scale Short Form score of 7 or more. Results: Twelve participants (35.3%) had depressive symptoms. The median total time spent in unsupervised training was significantly lower in the group with depressive symptoms (367 [249-799] sec) than in the group without depressive symptoms (888 [579-901] sec), with a medium effect size (U = 57, p = 0.006, Cohen's r = 0.46). No significant differences were found in the secondary outcomes (p > 0.05). Conclusions: Depressive symptoms were associated with reduced participation in unsupervised training among inpatients after stroke. The findings highlight the importance of considering psychological factors in designing and implementing self-rehabilitation programs at the early stages of rehabilitation.

The authors have declared no competing interest.

This work was supported by a grant from JSPS KAKENHI Grant Number JP20K21752 to S.T.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study was approved by the ethics committees of the Tokyo Bay Rehabilitation Hospital (approval number: 166-3) and Shinshu University (approval number: 5065).

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Yes

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

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All data produced in the present study are available upon reasonable request to the authors.