Quality Of Life In Stroke Patients Research Articles

How stroke-related dysphagia relates to quality of life: the mediating role of nutritional status and psychological disorders, and the moderating effect of enteral nutrition mode.

Although stroke-related dysphagia has been shown to influence quality of life (QOL), the underlying mechanisms have yet to be uncovered. This study aims to investigate the mediating role of nutritional status and psychological disorders in the relationship between stroke-related dysphagia and QOL in stroke patients and explore the moderating effect of enteral nutrition mode. In 2022, A questionnaire survey using stratified random sampling was conducted on 5,322 stroke patients with dysphagia, including Functional Oral Intake Scale (FOIS), Swallowing Quality of Life Questionnaire, Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) to assess dysphagia, QOL and psychological disorders, respectively, for each participant. Records of serum albumin, Hemoglobin, Total serum protein, serum prealbumin and Body mass index were enrolled to assess nutritional status. FOIS demonstrated a significant positive predictive effect on QOL. Nutritional status and psychological disorders (PHQ-9 and GAD-7) mediated the relationship between FOIS and QOL. Nutritional status-psychological disorders showed a chain mediation effect in the relationship between FOIS and QOL. The moderating effect of enteral nutrition mode was observed. The mediating role of nutritional status and psychological disorders with moderating effect of enteral nutrition mode in the relationship between dysphagia and QOL in stroke patients was found.

Non-pharmacological interventions on quality of life in stroke survivors: A systematic review and meta-analysis.

Non-pharmacological interventions have been used in the rehabilitation of stroke survivors, but their effects on stroke survivors' quality of life (QoL) are unknown. This review aimed to summarize the existing evidence regarding non-pharmacological interventions for QoL in stroke survivors and to evaluate the effectiveness of different types of interventions. We systematically searched databases including PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chinese BioMedical Literature Database, China Science and Technology Journal Database, and Wanfang data from the earliest available records to March 2023. Randomized controlled trials which explored the effects of non-pharmacological interventions on QoL in stroke patients were included. The meta-analysis was conducted to evaluate the effectiveness of different interventions on QoL. The Review Manager 5.3 was used to conduct the meta-analysis and the revised Cochrane risk-of-bias tool was used to assess the methodological quality of trials. A total of 93,245 records were identified, and 34 articles were reviewed and summarized, of which 20 articles were included in the meta-analysis. The summary of the findings of the included studies revealed fitness training, constraint-induced movement therapy (CIMT), physical exercise, music therapy (MT), and art-based interventions may have positive effects on QoL. The fitness training improved total QoL, especially in physical domains including physical functioning (mean difference [MD] = 10.90; 95% CI [7.20, 14.59]), role physical (MD = 10.63; 95% CI [6.71, 14.55]), and global health (MD = 8.76; 95% CI [5.14, 12.38]). The CIMT had a slight effect on general QoL (standardized mean difference [SMD] = 0.48, 95% CI [0.16, 0.80]), whereas significantly improved strength (MD = 8.84; 95% CI [1.31, 16.38]), activities of daily living/instrumental activities of daily living (ADL/IADL; MD = 10.42; 95% CI [2.98, 17.87]), and mobility (MD = 8.02; 95% CI [1.21, 14.83]). MT had a positive effect on the mental health domain (SMD = 0.54; 95% CI [0.14, 0.94]). Our findings suggest that fitness training and CIMThave a significant effect on improving physical QoL, while MThas a positive effect on improving psychological QoL. Future studies may use comprehensive and multicomponent interventions to simultaneously improve the patients' physical, psychological, and social QoL.

Association of multidimensional frailty and quality of life in middle-aged and older people with stroke: A cross-sectional study.

The aims of this study were to (i) compare the prevalence of multidimensional frailty in middle-aged and older people with stroke and to (ii) explore the relationship between multidimensional frailty and quality of life (QoL) in this patient population. In recent years, stroke patients have become increasingly younger. As an important risk factor for stroke patients, frailty has gradually drawn research attention because of its multidimensional nature. This study used a cross-sectional design. The study included 234 stroke patients aged 45 and older. Multidimensional frailty was defined as a holistic condition in which a person experiences losses in one or more domains of human functioning (physical, psychological and social) based on the Tilburg Frailty Indicator, and QoL was based on the short version of the Stroke-Specific Quality of Life Scale. Hierarchical regression was used to analyse the correlation factors of QoL. STROBE checklist guides the reporting of the manuscript. A total of 128 (54.7%) participants had multidimensional frailty, 48 (44.5%) were middle aged and 80 (63.5%) were older adults. The overall QoL mean score of the participants was 47.86 ± 9.04. Multidimensional frailty was negatively correlated with QoL. Hierarchical regression analysis showed that multidimensional frailty could independently explain 14.6% of the variation in QoL in stroke patients. Multidimensional frailty was prevalent in middle-aged and older people with stroke, and it was a significant factor associated with QoL in stroke patients. This study emphasises the importance of the early identification of multidimensional frailty. And targeted interventions should be studied to prevent the occurrence of multidimensional frailty and thereby improve the QoL of patients. There are no patient or public contributions to this study.

Effectiveness of Virtual Reality Training on Upper Limb Motor Function in Stroke Patient’s: A Randomized Control Trial

Stroke survivor has a poor quality of life (QOL) and by and large dependent on their activities of daily living(ADL). Rehabilitation of motor function is a prerequisite for enhancing QOL in stroke patients. Hence, a morenovel approach to the rehabilitation of stroke patients is the need of the hour. One such approach which is gainingattention in recent times is virtual reality (VR) training.Aim of the study: To evaluate the effectiveness of virtual reality training on Fugl-Meyer assessment (FMA) upperLimb (UL) motor function in stroke patients.Study design: Randomized control trial (RCT) - parallel group design, single-blind study.Methods: Forty eligible stroke patients were selected and assigned randomly either into VR training (Group A) ormotor relearning program without a VR system. The training was provided for six weeks, five sessions per week.FMA-UL motor function was evaluated at the beginning of the study before the commencement of the treatmentand again after six weeks following the completion of the entire treatment sessions.Results: There was a significantly higher improvement in the FMA-UL motor function in VR training; the meandifference in the improvement was 11.25 points compared to the motor relearning program performed without VRenvironment, the mean difference was 7.10 points.Conclusion: It is concluded that VR training was effective in improving FMA-UL motor function in stroke patients.

Association between depression and quality of life in stroke patients: The Korea National Health and Nutrition Examination Survey (KNHANES) IV-VII (2008-2018).

Stroke and depression are common diseases that affect quality of life (QoL). Although some recent studies have investigated the association between the two diseases, studies that examined the association between stroke, depression, and QoL are rare, with large-scale national-level studies lacking. We aimed to investigate the association between depression and QoL in stroke patients. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) IV-VII conducted in 2008-2018 were used, and 45,741 adults who were aged >40 years and had no missing data for stroke and depression were included in the analysis. The participants were first grouped by prevalence of stroke, and further divided by prevalence of depression. The overall prevalence of stroke was 3.2%, and the incidence was 9% higher in men than in women. Multiple logistic regression was performed after adjusting for demographic factors, health-related factors, and disease-related factors. The results confirmed that the stroke group with depression had a lower overall health-related quality of life, measured using EQ-5D, score compared to the stroke group without depression (-0.15). Moreover, the concurrent stroke and depression treatment group had the highest OR of 7.28 (95% CI 3.28-16.2) for the anxiety/depression domain. Depression was strongly associated with QoL in stroke patients. This association was more evident in stroke patients undergoing treatment for depression. Thus, clinical approaches that take QoL into consideration are needed for stroke patients with depression.

POST STROKE DEPRESSION AND ANXIETY: PREVALANCE AND CORRELATES

Objectives: The objective of the study is to evaluate the prevalence of depression and anxiety in post-stroke patients and identify its predictors. Materials and Methods: This study was conducted for a period of 6 months among 81 patients admitted with stroke in SSIMS and RC, Davangere. The information compiled from patient data collection form was assessed for comorbid conditions and type of stroke. Assessment for depression and anxiety was conducted using Hamilton D (HAM-D) and HAM-A scale and information of location of lesion was obtained from patient’s neuroimaging results. Quality of life (QOL) of post-stroke was assessed using stroke and aphasia QOL (SAQOL) questionnaire. Follow-up was conducted for patients who were diagnosed with depression and anxiety within 1 to 3 months. Results: Depression was more prevalent as compared to anxiety in post-stroke patients and was predominant in males and between the ages 61 and 70 years. Hypertension and diabetes were found to be a major comorbid conditions in such patients. Factors contributing to increased risk of depression and anxiety after stroke include age, sex, comorbidities, lesion location, and type of stroke. Post-stroke depression (PSD) and anxiety showed statistically significant association with left-sided lesion. Conclusion: PSD and anxiety are a relatively common complications and can result in poor QOL in stroke patients. Early detection of depression and anxiety symptoms may assist functional recovery and improve QOL in stroke patients. Careful evaluation of PSD and post-stroke anxiety should be integrated into clinical care of stroke patients.

Increased quality of life in patients with stroke during the COVID-19 pandemic: a matched-pair study

Patients with stroke are likely to experience impaired health-related quality of life (QOL), especially during the COVID-19 pandemic. This study aimed to evaluate the QOL of Chinese patients with stroke during the pandemic and explore the associated variables. A matched-pair, multicenter survey was conducted before and during the COVID-19 pandemic. Questionnaires including the 36-item Short-Form Health Survey (SF-36), the Activities of Daily Living (ADL) scale, and the Questionnaire about the Process of Recovery (QPR) were used. A total of 172 matched pairs (344 patients) were recruited in this study. Hierarchical multiple regression analysis was performed to analyze variables associated with QOL. Physical and mental component scores (PCS and MCS) were higher among the stroke patients during the pandemic (44.20 ± 18.92 and 54.24 ± 19.08) than before the pandemic (37.98 ± 14.52 and 43.50 ± 20.94). Pandemic stress, demographic and clinical characteristics were negative variables associated with PCS and MCS. QPR was positively associated with PCS and MCS. The QOL of Chinese stroke patients was higher during than before the COVID-19 pandemic. Pandemic stress aggravated stroke patients’ QOL, while personal recovery could alleviate the detrimental effect of pandemic stress on QOL for stroke patients.

Factors Affecting Quality of Life among Post-Stroke Patients in the Sub-Himalayan Region.

Background Stroke is one of the most debilitating conditions contributing to significant disability and death globally. Identifying risk factors for quality of life (QoL) will enable to improve home-based rehabilitation in post-stroke phase. Objective This study was aimed to identify the risk factors of QoL in stroke patients in the sub-Himalayan region. Materials and Methods A cross-sectional hospital-based study assessed the QoL among stroke patients within a week after the onset of acute stroke and then re-evaluated at 3 months. World Health Organization QoL-BREF, Beck Depression Inventory, the Barthel Index, and Montreal Cognitive Assessment (MOCA) were used to seek data on QoL, depression, cognitive, and functional dependence status, respectively. Appropriate statistics were used to compute the results. Results In total, 129 stroke patients recruited, out of which 102 returned to a 3-month follow-up. QoL, MOCA, disability index, and depression score were compared using Wilcoxon Singed-rank test. In multivariate analysis, depression and disability together predicted 60% of the variance for physical QoL ( p < 0.0001). Similarly, poststroke depression and disability together predicted 61% of the variance for psychological QoL ( p < 0.0001) in stroke patients. Conclusion Findings indicated that depression and disability are leading risk factors of QoL in stroke patients. Early identification of poststroke depression and functional dependence status is, therefore, essential to devise screening procedure and to develop targeted intervention to improve rehabilitation outcomes.

Effect of Cognitive Therapy Combined with Psychological Intervention on Anxiety State, Sleep Quality and Life Quality of Stroke Patients with Anxiety

Effect of Cognitive Therapy Combined with Psychological Intervention on Anxiety State, Sleep Quality and Life Quality of Stroke Patients with Anxiety

The course of post-stroke bladder problems and their relation with functional and mental status and quality of life: A six-month, prospective, multicenter study.

The aim of this study was to evaluate the frequency and course of post-stroke lower urinary tract dysfunction (LUTD) from early term up to a period of six months and to investigate the relation of LUTD with functional and mental status and quality of life (QoL) in stroke patients. This prospective study included a total of 70 stroke patients (44 males, 26 females; mean age 62.7±7.0 years; range, 46 to 79 years) from five different centers across Turkey between June 2015 and January 2017. The patients were questioned using the Danish Prostatic Symptom Score (DAN-PSS) to evaluate LUTD and evaluated using the Modified Barthel Index (MBI), Incontinence QoL Questionnaire (I-QOL), and Mini-Mental State Examination (MMSE) at one, three, and six months. At least one symptom of LUTD was observed in 64 (91.4%), 58 (82.9%), and 56 (80%) of the patients according to the DAN-PSS at one, three, and six months, respectively. A statistically significant improvement was found in the DAN-PSS, MBI, MMSE, I-QOL total scores, avoidance and psychosocial subgroup scores at six months compared to the first month scores (p<0.05). There was a significant negative correlation between the DAN-PSS symptom score at one month and the MBI, MMSE, and QoL scores at six months. The DAN-PSS bother and total scores were found to be significantly and negatively correlated only with the subscales of the QoL questionnaire. Based on our study results, LUTD was very common and the prevalence of LUTD findings decreased constantly during six-month follow-up, showing an association with a poor cognitive and functional status and QoL in stroke patients with LUTD.

Correlation of the gait speed with the quality of life and the quality of life classified according to speed-based community ambulation in Thai stroke survivors.

Gait abnormality commonly resulted from stroke which affected patients living and probably quality of life (QOL). To assess the relationship between gait speed and the QOL in Thai stroke patients and to compare the QOL among three patient groups that were categorized by gait speed: i) household ambulators <0.4 m/s, ii) limited community ambulators 0.4-0.8 m/s and iii) community ambulators >0.8 m/s. This was a cross-sectional descriptive research study. The demographic data of 92 stroke patients at Songklanagarind Hospital in Thailand were collected. The gait speed was calculated by the 10 meter walk test. The Thai version of the Stroke Impact Scale (SIS) 3.0 evaluated the QOL of the patients. The gait speed was correlated with the SIS score (r = 0.64, p < 0.001). The relationship between the gait speed and most domains of the SIS (i.e., strength, mobility, hand function, activities of daily living [ADL], emotion, social participation and thinking of recovery) were also statistically significant. The community ambulators had a higher total SIS score (729.8) than the limited community (600.8) or household ambulators (478.8) (p < 0.001). For each SIS domain mentioned above, there were significant mean scores except for emotion in the community ambulators compared with the others. The gait speed was significantly correlated with the physical domains of the QOL in stroke patients. The community ambulators had the highest QOL among the three groups.

Obstructive sleep apnea exaggerates cognitive dysfunction in stroke patients

BackgroundObstructive sleep apnea (OSA) is very common in stroke survivors. It potentially worsens the cognitive dysfunction and inhibits their functional recovery. However, whether OSA independently damages the cognitive function in stroke patients is unclear. A simple method for evaluating OSA-induced cognitive impairment is also missing. MethodsForty-four stroke patients six weeks after onset and 24 non-stroke patients with snoring were recruited for the polysomnographic study of OSA and sleep architecture. Their cognitive status was evaluated with a validated Chinese version of Cambridge Prospective Memory Test. The relationship between memory deficits and respiratory, sleeping, and dementia-related clinical variables were analyzed with correlation and multiple linear regression tests. ResultsOSA significantly and independently damaged time- and event-based prospective memory in stroke patients, although it had less power than the stroke itself. The impairment of prospective memory was correlated with increased apnea–hypopnea index, decreased minimal and mean levels of peripheral oxygen saturation, and disrupted sleeping continuity (reduced sleep efficiency and increased microarousal index). The further regression analysis identified minimal levels of peripheral oxygen saturation and sleep efficiency to be the two most important predictors for the decreased time-based prospective memory in stroke patients. ConclusionsOSA independently contributes to the cognitive dysfunction in stroke patients, potentially through OSA-caused hypoxemia and sleeping discontinuity. The prospective memory test is a simple but sensitive method to detect OSA-induced cognitive impairment in stroke patients. Proper therapies of OSA might improve the cognitive function and increase the life quality of stroke patients.

A comparison of the swallowing function and quality of life by oral intake level in stroke patients with dysphagia.

[Purpose] This study was conducted to compare the swallowing function and quality of life (QOL) in stroke patients with dysphagia by oral intake level. [Subjects and Methods] Seventy-nine stroke patients with dysphagia were enrolled. All subjects were evaluated by using the Swallowing Function Test (SFT) and the Swallowing Quality of Life (SWAL-QOL) questionnaire. The subjects were divided into two group based on the SFT score: oral intake (OI) and non-oral intake (NOI) groups. The SFT and SWAL-QOL scores were then compared between the groups. [Results] There were significant differences in items in the SFT, except for the respiratory item, between the OI group and the NOI group. There were significant differences in all items on the SWAL-QOL, except for the sleep item, between the OI group and the NOI group. [Conclusion] Oral intake was positively associated the swallowing function and QOL in stroke patients with dysphagia. Safe intervention using oral intake treatments during dysphagia rehabilitation may have a positive effect on the patients’ swallowing function and QOL.

Effect of Direct Feeding Intervention on Swallowing Function and Life Quality of Stroke Patients

Effect of Direct Feeding Intervention on Swallowing Function and Life Quality of Stroke Patients

The Effects of Walking, Massage and Taping Treatments on the Serum Inflammatory, Serum Lipids, Electromyography, Gait and Life Quality of Stroke Patients

PURPOSE The purpose of this study was to examine the effects of walking, kinesiotaping and massage treatments on the serum inflammatory factors, serum lipids, electromyography, and life quality of stroke patients. METHODS The participants were composed of 36 stroke patients divided into 3 groups (walking group; WG), taping and walking group (WG), massage, taping and walking group; MTWG). Stroke patients participated in a supervised training program for 12 weeks (3-4 days/week, 20-40 min/session). We measured EMG, lipid, inflammatory, gait and life quality on 0, 4, 8, 12 week each period. RESULTS After walking, massage and taping treatments, CK (p<.001), LDH (p<.001), and CRP (p<.001) were significantly difference in TWG, MTWG groups. TC (p<.01), TG (p<.05) were significantly difference in TWG, MTWG groups. EMG, SS-QOL and 10 m gait were significantly interaction after 12 weeks. CONCLUSIONS The results indicated that walking, massage and taping treatments had positive effect on the serum inflammatory factors, serum lipids, electromyography and life quality of stroke patients. 색인어: 마사지, 혈중염증, 혈중지질, 보행, 뇌졸중 Keywords: Massage, Inflamatory, Lipids, Gait, Stroke

Musculoskeletal and central pain at 1year post-stroke: associated factors and impact on quality of life.

Pain is common in post-stroke patients and has been shown to be associated with depression, fatigue, and decreased quality of life (QOL). However, studies examining different types of post-stroke pain are scarce. We investigated differences in the related factors and their QOL impacts between musculoskeletal pain (MSP) and central post-stroke pain (CPSP). We assessed 364 consecutive stroke patients who were admitted to Asan Medical Center and contacted 12months after stroke onset. We categorized pain and paresthesia as MSP, CPSP, combined pain, or other pain. Post-stroke depression (Beck Depression Inventory), fatigue (Fatigue Severity Scale), sleep disturbance (Verran Snyder-Halpern scale), social support (ENRICHED Social Support Instrument), and QOL (Medical Outcome Study 36-Item Short Form) were assessed. Of the 364 patients analyzed, 135 (37.1%) had pain, 78 (21.4%) had MSP, 22 (6.0%) had CPSP, 16 (4.4%) had combined pain, and 19 (5.2%) had other pain. In multivariate analyses, CPSP was related to modified Rankin scale (P=.004), sensory dysfunction (P<.001), thalamus lesion (P=.001), medulla lesion (P=.007), and fatigue (P=.026). MSP was related to motor dysfunction (P<.001) and fatigue (P=.003). QOL varied among groups with different types of pain (P<.001) and was the poorest in patients with combined pain. Pain is common 12months post-stroke. The factors associated with CPSP and MSP differ, but are both closely associated with fatigue rather than depression. QOL is the poorest in patients with combined pain. Management of pain and fatigue may be important for improving the QOL in stroke patients.

Predictors of functional level and quality of life at 6months after a first-ever stroke: the KOSCO study.

Predicting functional outcome and quality of life (QOL) is critical to the treatment of patients with stroke. The purpose of this study was to analyze the factors influencing functional status and QOL of stroke patients 6months after a first-ever stroke. This study was an interim analysis of the Korean Stroke Cohort for Functioning and Rehabilitation Study, designed to include 10years of follow-up for first-ever stroke patients. This study analyzed data from 2857 patients who completed face-to-face assessments with the functional independence measurement (FIM) and Euro Quality of Life-5D (EQ-5D) at 6months after stroke onset. A multivariate regression analysis was used to analyze factors that potentially influenced FIM and EQ-5D results at 6months after stroke. Of the patients in this study, 80.1% suffered from ischemic stroke and 19.9% experienced hemorrhagic stroke. The independent predictors of functional independency measured by FIM at 6months after stroke were age, initial stroke severity, duration of hospitalization, and functional level at discharge in terms of motor, ambulation, and language. For QOL measured by EQ-5D at 6months after stroke, age, duration of hospitalization, and motor function at discharge were significant predictors. In conclusion, proper treatment to achieve maximal functional gain at discharge may be an important factor in improving functional independency and QOL in chronic stage stroke survivors. These results provide useful information for establishing comprehensive and systematic care for stroke patients.

Warm needling on the four knee acupoints combined with Chinese herb in the treatment of knee pain after stroke

ObjectiveTo observe the clinical efficacy of warm needling on the four knee acupoints in the treatment of knee pain after stroke on the basis of Chinese herb. MethodsSixty patients with knee pain after stroke were divided into a group A and a group B by random allocation, with 30 patients in each group. Patients in the group B only received the treatment by Chinese herb, which called Dúhuó Jìshēng Tāng (▪ Pubescent Angelica and Mistletoe Decoction, add or remove ingredients depending on conditions); patients in the group A additionally received warm needling on the basis of Chinese herb. Four knee acupoints were selected as master acupoints and Hèd▪ng (▪ EX-LE 2), Yánglíngquán (▪ GB 34) and Zúsānlí (▪ ST 36) as combining acupoints. Perpendicular insertion was conducted on Xuèh▪i (▪ SP 10) and Liángqiū (▪ ST 34) for approximately 1 cun, and oblique insertion on Nèixīy▪n (▪ EX-LE 4) and Dúbí (▪ ST 35) for approximately 1 cun at 45° in inner and upper direction to push needle tip into joint cavity. After deqi, moxibustion stick was cut to 1.5 cm long, ignited, and inserted into the needle handles in the four knee acupoints. 1–2 strips were applied. After the moxa cones were burned up, needles were retained for 10 min. 7 d was a course of treatment and observation lasted for consecutive four courses. Visual analogue scale (VAS) and Barthel Index (BI) were adopted as observational indices. Clinical efficacy was classified as clinical cured, markedly effective, effective and ineffective according to the standards described in Guidelines of Clinical Research on Chinese New Herbal Medicine. ResultsAfter treatment, total effective rate was 93.3% in the group A, including full recovery in 8 cases, markedly effective in 15 cases, effective in 5 cases, and ineffective in 2 cases; while the total effective rate was 73.3% in the group B. The difference between the two groups was statistically significant (P<0.05). In the group A, VAS scores were 6.53 ± 1.39 before treatment and 1.53 ± 0.80 after treatment and BI scores were 58.38±8.67 before treatment and 67.55 ± 12.99 after treatment; in the group B, VAS scores were 6.63 ± 1.81 before treatment and 3.33 ± 0.96 after treatment and BI scores were 57.89 ± 9.65 before treatment and 64.87 ± 12.18 after treatment. Both VAS and BI scores were improved significantly in the two groups after treatment and the improvements were statistically significant (all P<0.05). Furthermore, both VAS and BI scores of group A were superior to that of group B (P<0.05). ConclusionAdditional treatment of warm needling on the four knee acupoints on the basis of Chinese herb can enhance the clinical efficacy in treatment of knee pain after stroke, contribute to the rapid recovery of knee function and improve the life quality of stroke patients.

Effects of therapeutic Tai Chi on balance, gait, and quality of life in chronic stroke patients.

The aim of this study was to analyze the effects of therapeutic Tai Chi on balance, gait, and quality of life in chronic stroke patients. Twenty-two inpatients diagnosed with stroke were divided randomly into two groups: one treated with both general physical therapy and Tai Chi exercise (11 patients) and one treated with only general physical therapy (11 patients). Therapeutic Tai Chi included 10 different movements and was performed for 60 min, twice per week, for 6 weeks. Pretest and post-test measurements were recorded for sway length and sway velocity using Gaitview, the functional reach test, the dynamic gait index, the 10-m walking test, the timed up-and-go test, and SF-36 survey. Both the Tai Chi group and the control group showed a significant improvement in sway length and sway velocity, and the Tai Chi group showed greater improvement than the control group in degree of variation. In addition, only the Tai Chi group showed a significant result for functional reach test, the dynamic gait index, the 10-m walking test, the timed up-and-go test, and the Tai Chi group improved. In the quality of life, the therapeutic Tai Chi group showed a significant improvement in five items (physical function, pain, vitality, general health, mental health) among eight items in SF-36. This study confirmed that therapeutic Tai Chi influences the balance, gait, and life quality of stroke patients. Therefore, therapeutic Tai Chi can be used as an effective exercise in combination with general physical therapy to improve the balance, gait, and quality of life in stroke patients.

Trends in In-Hospital Mortality among Patients with Stroke in China

BackgroundThe incidence and burden of stroke in China is increasing rapidly. However, little is known about trends in mortality during stroke hospitalization. The objectives of this study were to assess trends of in-hospital mortality among patients with stroke and explore influence factors of in-hospital death after stroke in China.Methods109 grade III class A hospitals were sampled by multistage stratified cluster sampling. All patients admitted to hospitals between 2007 and 2010 with a discharge diagnosis of stroke were included. Trends in in-hospital mortality among patients with stroke were assessed. Influence factors of in-hospital death after stroke were explored using multivariable logistic regression.ResultsOverall stroke hospitalizations increased from 79,894 in 2007 to 85,475 in 2010, and in-hospital mortality of stroke decreased from 3.16% to 2.30% (P<0.0001). The percentage of severe patients increased while odds of mortality (2010 versus 2007) decreased regardless of stroke type: subarachnoid hemorrhage (OR 0.792, 95% CI = 0.636 to 0.987), intracerebral hemorrhage (OR 0.647, 95% CI = 0.591 to 0.708), and ischemic stroke (OR 0.588, 95% CI = 0.532 to 0.649). In multivariable analyses, older age, male, basic health insurance, multiple comorbidities and severity of disease were linked to higher odds of in-hospital mortality.ConclusionsThe mortality of stroke hospitalizations decreased likely reflecting advancements in stroke care and prevention. Decreasing of mortality with increasing of severe stroke patients indicated that we should pay more attention to rehabilitation and life quality of stroke patients. Specific individual and hospital-level characteristics may be targets for facilitating further declines.