Life In Post-stroke Patients Research Articles

Proceedings #4: Repetitive Transcranial Magnetic Stimulation (rTMS) Improves Depressive Symptoms and Quality of Life of Post-Stroke Patients

Proceedings #4: Repetitive Transcranial Magnetic Stimulation (rTMS) Improves Depressive Symptoms and Quality of Life of Post-Stroke Patients

POST-STROKE PSYCHIATRIC DISORDERS: AN OVERVIEW ON ITS SCREENING AND MANAGEMENT

Stroke is the third leading cause of death. Stroke occurs when an insufficient amount of blood is supplied to the brain due to a thrombus or an emboli leading to permanent tissue damage. Lesions in the brain can lead to psychiatric complications. The prevalence of psychiatric complications after stroke is very common. Psychiatric complications such as depression, anxiety, apathy, pseudobulbar effects (laughing and crying), mania, psychosis, and bipolar disorders are seen after stroke. In this review, various psychiatric disorders are reported among post-stroke survivors in which depression and anxiety are common. Consequently, apathy, pseudobulbar effects, catastrophic reactions, psychosis, bipolar disorder, and mania are also observed after stroke. Therefore, early detection and management of psychiatric disorders prevent further complications and improve the quality of life in post-stroke patients.

POST-STROKE PSYCHIATRIC DISORDERS: AN OVERVIEW ON ITS SCREENING AND MANAGEMENT

Stroke is the third leading cause of death. Stroke occurs when an insufficient amount of blood is supplied to the brain due to a thrombus or an emboli leading to permanent tissue damage. Lesions in the brain can lead to psychiatric complications. The prevalence of psychiatric complications after stroke is very common. Psychiatric complications such as depression, anxiety, apathy, pseudobulbar effects (laughing and crying), mania, psychosis, and bipolar disorders are seen after stroke. In this review, various psychiatric disorders are reported among post-stroke survivors in which depression and anxiety are common. Consequently, apathy, pseudobulbar effects, catastrophic reactions, psychosis, bipolar disorder, and mania are also observed after stroke. Therefore, early detection and management of psychiatric disorders prevent further complications and improve the quality of life in post-stroke patients.

Traducción al castellano y análisis preliminar de las propiedades psicométricas del cuestionario Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) para valorar la calidad de vida en pacientes postictus

The Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) is one of the few specific questionnaires for evaluating the quality of life among patients who have suffered an ischaemic or haemorrhagic stroke.To translate and adapt this questionnaire into Spanish and to evaluate its reliability and acceptability.The original version of the NEWSQOL questionnaire was translated into Spanish. The translation was agreed upon by a team of experts, and was then back-translated into English and sent to the author, who gave her approval of the rendering. This version was later administered to a group of patients in order to evaluate its reliability, acceptability, floor effect and ceiling effect.The process of linguistic adaptation allowed semantic, conceptual and content equivalence to be achieved in the Spanish version of the NEWSQOL. The results obtained in the preliminary analysis show excellent acceptability, an internal consistency index of 0.9 for the whole questionnaire and a good or excellent test-retest agreement for all the domains. No ceiling effect was detected, but a floor effect was observed in the case of the vision and cognition domains.The Spanish version of the NEWSQOL questionnaire is reliable for evaluating the quality of life in post-stroke patients, as well as being well accepted. The questionnaire must be used in more broader samples in order to evaluate its validity and sensitivity.Traduccion al castellano y analisis preliminar de las propiedades psicometricas del cuestionario Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) para valorar la calidad de vida en pacientes postictus.Introduccion. El Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) es uno de los pocos cuestionarios especificos para valorar la calidad de vida en pacientes que han sufrido ictus isquemico u hemorragico. Objetivo. Traducir y adaptar dicho cuestionario al castellano y evaluar su fiabilidad y aceptabilidad. Pacientes y metodos. Se tradujo al castellano la version original del cuestionario NEWSQOL, traduccion que fue consensuada por un equipo de expertos, y a partir de la cual se hizo una retrotraduccion al ingles que se envio a la autora, quien mostro su conformidad. Posteriormente esa version se administro a un grupo de pacientes para valorar su fiabilidad, aceptabilidad, efecto suelo y efecto techo. Resultados. El proceso de adaptacion linguistica permitio obtener la equivalencia semantica, conceptual y de contenido de la version española de NEWSQOL. Los resultados obtenidos en el analisis preliminar reflejan una excelente aceptabilidad, un indice de consistencia interna de 0,9 para la totalidad del cuestionario y una concordancia test-retest buena o excelente para todos los dominios. No se detecto efecto techo, pero si efecto suelo para los dominios de vision y cognicion. Conclusion. La version española del cuestionario NEWSQOL es fiable para valorar la calidad de vida en pacientes postictus, ademas de aceptarse bien. Es necesario utilizar el cuestionario en muestras mas amplias para evaluar su validez y sensibilidad.

Quality of life and its influencing factors in post-stroke patients with depression

Post-stroke depression had a serious influence on treatment in later stage, physical and mental health and so on in patients, so how to improve and exactly evaluate the quality of life of post-stroke patients became focus topics in medical worker. This review summarized the frequently-used instruments for evaluating quality of life and influencing factors of quality of life in post-stroke patients with depression by searching literature. Generally, instruments for evaluating quality of life in post-stroke patients could be divided into two categories including universal instruments and and specific instruments. Influencing factors of quality of life involved personal factors, disease factors, social factors and so on. Key words: Post-stroke depression; Quality of life; Influencing factors

Effect of Underwater Exercise on Lower-Extremity Function and Quality of Life in Post-Stroke Patients: A Pilot Controlled Clinical Trial.

To date, controlled clinical trials evaluating the efficacy of underwater exercise in improving the lower-extremity function and quality of life (QOL) in post-stroke patients have yet to be conducted. The purpose of the present study was to determine whether repeated underwater exercise enhances the therapeutic effect of conventional therapy for post-stroke patients. This was a pilot controlled clinical trial. The study took place in a research facility attached to a rehabilitation hospital. This prospective trial included 120 consecutive post-stroke inpatients with hemiplegic lower limbs (Brunnstrom stage 3-6). Patients were assigned to either an experimental or a control group. Patients in the experimental group received both repeated underwater exercise and conventional rehabilitation therapy. The underwater exercise consisted of 30-min training sessions in a pool with a water temperature of 30-31°C in which patients followed the directions and movements of trained staff. Training sessions were conducted once a day on 2 days of the week for a total of 24 times. Patients in the control group received only the conventional therapy. The 10-Minute Walk Test (10MWT), the Modified Ashworth Scale, and the 36-Item Short Form Health Survey were the outcome measures used. Lower-extremity function and QOL were assessed before and upon completion of the 12-week program. Improvements in 10MWT results and spasticity parameters were greater in the experimental group than they were in the control group (p < 0.01). Significant differences between the groups were observed in magnitudes of changes of all QOL parameters (p < 0.01). Combining conventional therapy with repeated underwater exercise may improve both lower-extremity function and QOL in post-stroke patients.

Depression Post-Stroke: Clinical Characteristics Associated

Depression is an important variable related to the worsening of quality of life in post-stroke patients. This study aimed to identify the prevalence of depression in patients after stroke. It is a cross-sectional study conducted between February and April 2013, 51 patients admitted to specialized stroke unit in a hospital in Fortaleza, Ceara, Brazil. Hamilton Depression Rating Scale was applied to investigate depression. Regarding the modifiable risk factors, physical inactivity was the most significant factor for depression. As regards the neurological deficits, subjects with speech disorders had 2.2 times more likely to get depressive symptoms. The inability to walk did not affect the acquisition of these symptoms. On the comorbidities, non diabetics and heart disease ones had a 30% chance to further develop depression and hypertension does not influence in this. Thus, the study showed that among patients in the sample, younger women, unemployed, who had companion and had higher levels of education presented a greater chance of depression. We see, on this, the need to expand research in this context with longitudinal studies so these and other factors can be controlled through time.

Therapeutic possibilities of improvement of cognitive functions, psychoemotional condition and a quality of life in post-stroke patients

To study an influence of cytoflavin on normalization of cognitive functions, psychoemotional condition and a quality of life in stroke patients. It was analysed the results of treatment of 1450 stroke patients. The cognitive functions was followed up using MMSE and MoCA scales, psychoemotional condition--Beck Depression Questionnaire and Wakefield Depression Scale, Hamilton Scale of Anxiety, quality of life--Sickness Impact Profile. The results of the study revealed that the use of cytoflavin was well founded in the treatment of stroke patients for improvement of cognitive functions, psychoemotional condition and the quality of life.

A Novel Virtual Reality System Integrating Online Self-Face Viewing and Mirror Visual Feedback for Stroke Rehabilitation: Rationale and Feasibility

Purpose: To introduce the rationale of a novel virtual reality system based on self-face viewing and mirror visual feedback, and to examine its feasibility as a rehabilitation tool for poststroke patients. Method: A novel motion capture virtual reality system integrating online self-face viewing and mirror visual feedback has been developed for stroke rehabilitation.The system allows the replacement of the impaired arm by a virtual arm. Upon making small movements of the paretic arm, patients view themselves virtually performing healthy full-range movements. A sample of 6 patients in the acute poststroke phase received the virtual reality treatment concomitantly with conservative rehabilitation treatment. Feasibility was assessed during 10 sessions for each participant. Results: All participants succeeded in operating the system, demonstrating its feasibility in terms of adherence and improvement in task performance. Patients’ performance within the virtual environment and a set of clinical-functional measures recorded before the virtual reality treatment, at 1 week, and after 3 months indicated neurological status and general functioning improvement. Conclusions: These preliminary results indicate that this newly developed virtual reality system is safe and feasible. Future randomized controlled studies are required to assess whether this system has beneficial effects in terms of enhancing upper limb function and quality of life in poststroke patients.

Can EQ-5D and 15D be used interchangeably in economic evaluations? Assessing quality of life in post-stroke patients

This paper provides an analysis on the use of 15D and EQ-5D to measure health related quality of life. Measures like these are often used interchangeably in cost-effectiveness studies. However, it is unclear whether they measure the same level of health in the same patients. The empirical performance of the two multi-attribute utility instruments is tested in terms of feasibility, utility score, linear relationship and agreement by using a novel Norwegian data set. The paper also includes an analysis of how the instruments rank individuals in terms of health status, and their discriminatory power are tested. The results show that EQ-5D and 15D should not be used interchangeably in economic evaluations. EQ-5D is likely to give a more favourable cost utility ratio than 15D. The utility scores generated from the two instruments differ significantly different from each other, even though they correlate well. The instruments also rank individuals in terms of health status differently.

The regression analysis on quality of life of post-stroke patients and its influencing factors

Objective To explore the quality of life (QOL) of stroke patients and its influencing factors. Methods 101 patients received the observational research after one-month post-stroke. The assessment included a self-designed demography and disease scale, self-rating depression scale, social support scale and stroke impact scale (SIS). Results Regression analysis indicated that age, rehabilitation training, self-rating depression scores and self-rating recovery scores were four significant influencing factors of stroke patients' QOL (R2=0.519, P＜0.05). Conclusions The SIS was a feasible means of assessing post-stroke patients' QOL.Specialized rehabilitation training and specific mental intervention could improve the life quality of post-stroke patients. Key words: Quality of life(QOL); Post-stroke; Stroke impact scale (SIS); Clinical nursing research

FP37-WE-05 Impact of insomnia on the quality of life of post-stroke patients

FP37-WE-05 Impact of insomnia on the quality of life of post-stroke patients

Factors influencing outcomes in patients with stroke

Outcomes of stroke result in long-term disability in most of the patients. It has been confirmed by scientific studies that rehabilitation can improve functional status and quality of life of poststroke patients. The effectiveness of rehabilitation and the outcomes often differ among patients. For effective utilization of the rehabilitation resources, it is important to prognosticate the possible outcomes of the disorder. Recently, studies are performed with the aim to determine and evaluate factors possibly influencing functional recovery in poststroke patients and helping to distinguish patients with good outcome from those with poor outcome. Age, gender, initial severity of the stroke, functional status at admission to hospital, urinary incontinence, impairment in cognitive function, unilateral neglect syndrome are most often analyzed in scientific studies as factors determining the outcomes of the disorder.