Quality Of Life In Post-stroke Patients Research Articles

Assessment of the stroke-specific quality-of-life scale in KFHU, Khobar: A prospective cross-sectional study.

Objectives:To assess the overall and domain-specific quality of life (QOL) in post-stroke patients using the stroke-specific quality of life (SS-QOL) scale and to identify variables that may affect the QOL after stroke.Methods:A prospective cross-sectional study, included 80 stroke patients, was conducted in the Neurology department at King Fahad Hospital of the University (KFHU), Khobar, Saudi Arabia, from December 2019 to February 2020. Stroke patients were interviewed using the Arabic version of the SS-QOL questionnaire and modified Rankin scale (mRS).Results:The overall quality of life in the surveyed participants was at the level of 3.72 points, which is above the average recognized in the middle of the scale that ranges from 1 to 5. The overall quality of life was not significantly correlated with sex, age, type of stroke, recurrence of stroke, and time since stroke (p>0.05). Hypertension and atrial fibrillation were the only comorbidities that were determined to be significantly associated with the overall quality of life at the level of (3.53), and (2.97) respectively (p<0.05). There was a statistically significant correlation between the mRS score and the overall quality of life (p<0.05).Conclusion:Performing a comprehensive assessment of the overall QOL in post-stroke patients will result in better health outcomes, particularly in terms of quality of functioning in psycho-social aspects.

Measuring Quality of Life in Stroke Survivors

Introduction: The number of patients living with the consequences of stroke is increasing worldwide due to the improving stroke care and the modern differentiated treatment options for ischemic stroke – thrombolysis and thrombectomy. Hence, a significant interest has arisen in quality of life (QOL) measurement in post-stroke patients. Objectives. Measuring QOL in stroke survivors can be achieved by using various generic and stroke specific questionnaires. All tools should assess different domains of health such as physical acting, communication, daily activities and others. This article describes the most commonly used scales for measuring post-stroke QOL. Methods. We searched the PubMed electronic databases with the keywords — Quality of life, Stroke, Measuring for the period from January 2000 to May 2020. Results. Various generic and specific scales for quality of life measuring are available. The advantages of the specific scales include high accuracy and detailed information for the assessed domains. The limitations are due to numerous items, long evaluation time and high dependency on patient’s compliance. The generic scales give the ability to compare the QOL in patients with different diseases. The disadvantage is lack of detailed information for the health status in certain disease or condition. Conclusion. Measuring the different aspects of QOL in post-stroke patients is powerful tool in order to focus the further efforts to the most affected domains. A combination between generic and stroke-specific measure might be considered in order to overcome the limitations. The choice of measuring scales must be balanced in the terms of lengthy and repetitive surveys.

Intrathecal baclofen therapy versus conventional medical management in post-stroke spasticity: Assessment of patient-reported outcome: Quality of life, pain and satisfaction (SISTERS)

SISTERS is the first multicenter randomized trial demonstrating superiority of intrathecal baclofen (ITB) therapy versus conventional medical management (CMM) with oral antispastic in decreasing muscle hypertonia in lower and upper limbs of post-stroke patients with severe spasticity. Here we report Numeric Pain Rating Scale (NPRS), Quality of Life (QoL) assessed by EQ-5D and Stroke Specific QoL (SS-QoL), satisfaction and safety. Sixty stroke patients with spasticity in ≥ 2 extremities and an Ashworth Scale score ≥ 3 in ≥ 2 affected muscle groups in the lower limbs were randomized to ITB or CMM group and both arms received physiotherapy. Mean changes (SD) from baseline to month 6 in ITB patients versus CMM group were −1.17 (3.17) vs. 0.00 (3.29) for NPRS actual pain, −1.61 (2.29) vs. 0.24 (3.07) for NPRS least pain and 0.09 (0.26) vs. 0.01 (0.16) for EQ-5D utility score. These between-group differences were statistically significant ( P < 0.05, Wilcoxon test). ITB patients showed greater improvements in NPRS worst pain [−1.35 (2.42) vs. −0.04 (3.69)], EQ-5D health status [9.68 (20.42) vs. 4.40 (21.75)] and SS-QoL [0.26 (0.58) vs. 0.05 (0.58)], although between-group differences were not statistically significant. Extreme problems of individual EQ-5D dimensions at baseline were reported by 30%, 26%, 17% and 13% of ITB patients in self-care, usual activities, pain/discomfort and mobility, respectively. At 6 months there was a decrease in the percentage of patients reporting extreme problems for all domains except mobility. More ITB than CMM patients (73% vs. 48%) were satisfied with the spasticity reduction at month 6. In total 17 (68%) ITB implanted patients reported at least one treatment-related adverse events versus 7 (20%) in CMM group. No treatment-related adverse event led to discontinuation of ITB therapy. Reduction of muscle tone with ITB therapy is associated with improvements in pain and QoL in post-stroke patients with severe spasticity.

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.

Quality of life predictors in chronic stable post-stroke patients and prognostic value of SF-36 score as a mortality surrogate.

Perceived quality of life (QoL) and psychological well-being represents an important target of secondary prevention practice in post-stroke patients. We aimed to identify the major covariates of impaired QoL in stable post-stroke patients and whether impaired QoL itself represents independent mortality predictor.The study consisted of a cross-sectional and a prospective part. Three hundred forty-one patients [mean age 69.0 (SD 9.1)] were interviewed at least 6months after discharge from hospital for their first-ever ischemic stroke. QoL was objectivized using 36-Item Short-Form Health Survey (SF-36) scoring. Standard health-related questionnaires, including Hospital Anxiety and Depression Scale (HADS), risk factors, and biochemical markers, were assessed. To estimate the 5-year all-cause and cardiovascular mortality, we ascertained the vital status and declared cause of death.Anxiety, depression (HADS score ≥11), brain natriuretic peptide levels ≥100ng/mL, residual motor impairment at interview, Rankin Scale ≥4 at discharge from hospitalization, and raised blood pressure were identified as main determinants of impaired QoL in the cross-sectional part. The 5-year all-cause and cardiovascular mortality rates were 25.8 and 19.9%, respectively. After adjustment for potential covariates, patients with an SF-36 score ≤40 at baseline had more than a twofold higher risk of all-cause and cardiovascular mortality (with HRRs 2.01 (95% CI 1.21-3.32), p < 0.007 and 2.32 (95% CI 1.32-4.09), p < 0.003, respectively) during the 5years of follow-up.In conclusion, anxiety, depression, and raised brain natriuretic peptide levels were the most important covariates of impaired QoL in post-stroke patients. Moreover, a decreased SF-36 score (≤40) represents an independent surrogate of increased additive mortality risk.

Factors Associated with SF-12 Physical and Mental Health Quality of Life Scores in Adults with Stroke

Studies of poststroke quality of life (QOL) have not consistently identified which factors are most likely to independently influence the physical and mental aspects of QOL. In this study, we sought to identify which sociodemographic, comorbid disease conditions, and disability factors independently influenced the physical and mental aspects of poststroke QOL. We completed a cross-sectional study of 666 US adults with a history of stroke from the 2007 Medical Expenditure Panel Survey (MEPS). We used sequentially built multiple linear regression models to identify sociodemographic, comorbidity, and stroke-related disability factors that independently affected short form-12 (SF-12) physical component summary (PCS) and mental component summary (MCS) scores. STATA software (version 10; StataCorp LP, College Station, TX) was used to perform the analysis to account for the complex survey design of the MEPS. In fully adjusted models using a nationally representative sample of US adults, being non-Hispanic black (β = 3.58), 45 to 64 years of age (β = -3.48), 65 years of age or older (β = -2.90), married (β = -3.50), middle (β = 2.78) and high income (β = 3.73), or having hypertension (β = -2.25), cardiovascular disease (β = -2.05), arthritis (β = -4.49), depression (β = -2.98), physical limitations (β = -7.60), social limitations (β = -4.12), and a need for assistance with instrumental activities of daily living (β = -4.49) were independently correlated with PCS scores. Being 45 to 64 years of age (β = 3.96), depressed (β = -15.92), or having social limitations (β = -3.62) were independently correlated with MCS scores. Sociodemographic, comorbidity, and stroke-related disability factors have differential effect on physical and mental aspects of QOL in poststroke patients.