Correlation of Upper Extremity Function to Quality of Life of Primary Caregivers of Ambulatory Stroke Survivors Living in the Community (original) (raw)
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Cardiorespir Physiother Crit Care Rehabil, 2021
Background: The Six-Minute Walk Test (6MWT) predicts community ambulation in stroke patients. These patients frequently face several disabilities, including upper extremity dysfunction. Since upper extremity (UE) dysfunction is related to walking disability, we expect that the UE function is associated with the 6MWT. So far, no study has directly investigated the association between UE function and the 6MWT. Aims: To examine the association between UE function and the 6MWT in stroke survivors adjusted for balance and gait problems. Methods: Subjects were randomly recruited from the general population and the Academic Hospital Paramaribo. UE function was measured using the handgrip strength (HGS) test, Disabilities of the Arm Shoulder and Hand (DASH) survey and Stroke Impact Scale (SIS) survey. Functional walking capacity was measured by the 6MWT. Functional balance was measured using the Berg Balance Scale (BBS). Step length ratio (SLR) and step width (SW) were used to assess gait. The median (range) or mean±SD are presented. Results: In fifty subjects with a mean age of 58.2±9.5 years, we demonstrated that the mean 6MWT (297.9±19.8m) correlated with the mean paretic HGS (19.1±14.9kg, r=0.77, p<0.001) and non-paretic HGS (31.1±9.7kg, r=0.41, p=0.003), but not with the DASH and SIS surveys. The 6MWT correlated with the BBS (55.0(30.0-56.0), r=0.51, p<0.001), SLR (0.9(1.0-2.0), r=-0.29, p=0.044), but did not correlate with SW. After adjusting for BBS and SLR, paretic HGS explained 62% of the variance in 6MWT. The relationship between non-paretic HGS and 6MWT was influenced by the BBS and SLR (p<0.05, R 2 =0.39). Conclusions: Paretic handgrip strength predicts 6MWT performance after adjusting for balance and gait asymmetry. The 6MWT is limited by stroke-related impairments such as handgrip strength, balance control and gait asymmetry. Further studies are warranted for assessment of causal effects between these variables.
Functional Ability and Health Problems of Stroke Survivors: An Explorative Study
Cureus
Background A stroke is an emergency medical condition that needs to be treated promptly. Patients who suffer from stroke frequently experience varying degrees of impairment, necessitating emergency hospital treatment and prolonged home care. It can lower the quality of life which leads to social isolation and makes it harder to function independently. The purpose of this research was to assess the health issues and functional capacity of individuals living with stroke. Methodology An exploratory study was conducted in the neurological outpatient department of tertiary care hospitals in Chennai. A total of 30 post-stroke participants were selected using a convenient sampling technique. Data were collected by structured interviews using the Post-Stroke Checklist and Barthel Index. The data were analyzed through descriptive and inferential statistics. Results The majority of the patients were (86.7%) men in the age group of 55-65 years. Regarding the health problems identified with the Post-Stroke Checklist, the activities of daily living (80%) were the most common, and spasticity (48%) and pain (34%) were the least common. However, 60% of the participants had new problems related to vision, 66% had problems with hearing, 76% had problems with getting around inside or outside, and 60% had a history of a recent fall. Further, 52% had problems with remembering and concentrating on things, 72% had problems sleeping, and 45% were worried about their relationship with their spouse after the stroke. The median Barthel Index score was 43.5. Conclusions More than half of all stroke survivors were dependent on others for everyday activities. We recommend that a well-designed and focused assessment is needed to identify the functional ability and stroke-related health problems among individuals by all healthcare professionals for the successful rehabilitation of stroke survivors.
BMC Neurology, 2016
Background: Despite that disability of the upper extremity is common after stroke, there is limited knowledge how it influences self-perceived ability to perform daily hand activities. The aim of this study was to describe which daily hand activities that persons with mild to moderate impairments of the upper extremity after stroke perceive difficult to perform and to evaluate how several potential factors are associated with the self-perceived performance. Methods: Seventy-five persons (72 % male) with mild to moderate impairments of the upper extremity after stroke (4 to 116 months) participated. Self-perceived ability to perform daily hand activities was rated with the ABILHAND Questionnaire. The perceived ability to perform daily hand activities and the potentially associated factors (age, gender, social and vocational situation, affected hand, upper extremity pain, spasticity, grip strength, somatosensation of the hand, manual dexterity, perceived participation and life satisfaction) were evaluated by linear regression models. Results: The activities that were perceived difficult or impossible for a majority of the participants were bimanual tasks that required fine manual dexterity of the more affected hand. The factor that had the strongest association with perceived ability to perform daily hand activities was dexterity (p < 0.001), which together with perceived participation (p = 0.002) explained 48 % of the variance in the final multivariate model. Conclusion: Persons with mild to moderate impairments of the upper extremity after stroke perceive that bimanual activities requiring fine manual dexterity are the most difficult to perform. Dexterity and perceived participation are factors specifically important to consider in the rehabilitation of the upper extremity after stroke in order to improve the ability to use the hands in daily life.
Archives of Physical Medicine and Rehabilitation, 2018
Few stroke scales for upper limb movements include movement quality when assessing task completion. Assessing movement quality is important because it provides information about how a person accomplishes a task, including compensatory movements and joint limitations. This is essential information for the therapist to guide individualized treatment and optimize recovery. 1 The Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES) assesses quality and quantity of upper limb daily life functional movements in stroke. Because tone, muscle contractions, and active movements are scored by a therapist, the scale is useful for people with no active arm or hand function to minimal motor impairments. 2 MESUPES has a MESUPES-ARM section (8 items) and a MESUPES-HAND section (9 items) and takes 5-15 minutes to complete. 2 MESUPES-ARM and MESUPES-HAND have excellent inter-rater reliability, 2,3 internal consistency and construct validity, evaluated with Rasch Measurement Theory. 2 Rasch Measurement Theory converts an ordinal scale to an interval scale (measured in logits) for more precise measurement of change. The hierarchy from easy to difficult items is maintained across demographic and clinical subgroups. 2 Conversion from total scores for both subscales to logits to a Rasch-converted percentage score can be requested from avandewi@ umn.edu. Plans are made to publish the conversion table. Both subscales have excellent convergent validity with the Modified Motor Assessment Scale and Stroke Upper Limb Capacity Scale, ranging from rZ0.84-0.91. 3,4 SEM and minimal detectable change values are available. 3 In sum, the reliability, validity, unidimensionality of the subscales and invariance across stroke subgroups support clinical use of MESUPES in people with stroke. This abbreviated summary provides a review of the psychometric properties of the MESUPES in people with stroke. A full review of the MESUPES and reviews of over 400 other instruments for patients with various health conditions can be found at: www.sralab.org/ rehabilitation-measures.
Predictors of Health-Related Quality of Life in Stroke Survivors After Inpatient rehabilitation
2019
Background. Disordered and decreased quality of life is the most important consequence of stroke for stroke survivors. The aim of the study was to determine the predictors of the health-related quality of life (HRQOL) in stroke survivors six months after discharge from inpatient rehabilitation. Methods. We conducted prospective cohort study which involved 136 (48.5% males and 51.5% females) survivors. We examined seven potential predictors of HRQOL: age, sex, stroke type, stroke side, functional status (Barthel Index-BI and modified Rankin Scale-mRS), cognition (Mini-Mental State Examination; MMSE) and stroke severity (National Institutes of Health Stroke Scale; NIHSS). HRQOL was assessed by Stroke Impact Scale (SIS) 3.0. Using Pearson's correlation and multiple logistic regression analysis we described the relationships between mRS, NIHSS, BI, MMSE and HRQOL. Results. Baseline mRS and NIHSS scores negatively correlated with seven SIS domains except with strength. Baseline BI scores positively correlated with seven SIS domains except mobility and baseline MMSE scores positive correlated with memory, ADL, hand function and participation role and negatively correlated with emotion, communication and mobility domains. Decrease of both mRS and NIHSS scores during the observed period positively correlated with increase of all SIS domains. Ischaemic stroke positively correlated with emotion and communication and stroke in brainstem negatively correlated with communication domain. Memory domain positively correlated with female sex and with stroke in the right hemisphere. Age wasn't significantly associated with any SIS domain. Conclusion. We conclude that major factors in predicting the improvement of strength, physical functioning, mobility, hand function, ADL and participation role were increase of BI and decrease of mRS and NIHSS scores. Female sex, stroke in right hemisphere and increase of BI and MMSE scores predicted better memory. Baseline mRS and NIHSS scores were predictors for improvement of hand function and increase of mRS predicted decrease of hand function and participation role.