Stroke Specific Quality Of Life Scale Research Articles

Association of Neighborhood Recreation Centers and Poststroke Outcomes in a Population-Based Cohort.

Higher neighborhood socioeconomic status has been favorably associated with stroke outcomes. This may be due to these areas having more beneficial resources such as recreational centers. We aimed to determine if neighborhood density of recreation centers is favorably associated with stroke outcomes. We conducted analyses of data from the Brain Attack Surveillance in Corpus Christi project, a cohort of stroke survivors ≥45 years of age residing in Nueces County, TX (2009-2020). We included non-Hispanic White and Mexican American incident stroke survivors, who were not institutionalized prestroke and completed baseline and follow-up assessments (N=1392). We calculated the density of fitness and recreational sports centers within their residential census tract during the year of their stroke. Outcomes included function (self-ratings on activities of daily living and instrumental activities of daily living), cognition (modified mini-mental state exam), depression (Patient Health Questionnaire-8), and quality of life (abbreviated Stroke-Specific Quality of Life Scale). We fit confounder-adjusted gamma-distributed mixed generalized linear models with a log link for each outcome and considered interaction with stroke severity. On average, participants were 65 years old, 53% male, and 63% Mexican American. Median recreational centers were 1.60 per square mile (interquartile range, 0.41-3.06). Among moderate-severe stroke survivors, greater density of recreation centers (75th versus 25th percentile) was associated with more favorable function and possibly quality of life (activities of daily living/instrumental activities of daily living, 4.8% change [95% CI, -0.11% to -9.27%]; Stroke-Specific Quality of Life Scale, 3.7% change [95% CI, -0.7% to 8.2%]). Minimal nonsignificant differences were observed among the overall stroke population and those with mild stroke. The availability of recreation centers may be beneficial for poststroke function and quality of life among those with moderate-severe stroke. If further research confirms recreation centers to be beneficial, this could inform rehabilitation following stroke.

Effect of Qigong exercise on non-motor function and life quality in stroke patients: A systematic review and meta-analysis.

Qigong have a positive impact on the rehabilitation of motor function in stroke survivors, but there is no consensus on the effectiveness of Qigong on activities of daily living (ADL), neurological function, and life quality for patients with stroke. We aimed to quantitatively evaluate the effect of Qigong on non-motor function and life quality in stroke patients. Electronic literature searches were performed for randomized controlled trials on this topic using PubMed and China National Knowledge Infrastructure through August 2022. The primary outcome measures were the Barthel Index, neurological deficit score (NDS), and Stroke-Specific Quality of Life Scale (SSQLS). A random-effects model was used to calculate the pooled mean difference (MD) with 95% confidence interval (CI). RevMan 5.4 software was used for meta-analysis. A total of 16 eligible randomized controlled trials with 1253 stroke patients were included. As indicated by the Barthel Index, Qigong was associated with the improvement in daily living activities of stroke patients (MD: 10.72, 95% CI: 5.88∼15.57). It was also found that Qigong was helpful in improving life quality (SSQLS, MD: 14.41, 95% CI: 5.56∼23.25) and reducing NDSs among them (NDS, MD: -4.56, 95% CI: -6.99∼-2.14). After sensitivity analysis, the effect of Qigong on these functions and life quality did not change significantly. By subgroup analysis of intervention duration, we found that long-term intervention (MD: 11.83, 95% CI: 2.80∼20.86) had a better effect on the improvement of daily living activities than short-term intervention (MD: 10.07, 95% CI: 6.15∼14.00) (pfor subgroup differences =.001). Pooled results suggested that Qigong had beneficial effects on ADL, neurological function, and life quality in stroke patients, which may provide an option for their rehabilitation.

Effects of Mirror Therapy Combined With Task-Oriented Training on Limb Function Recovery in Stroke Patients With Hemiplegia

To explore the effects of mirror therapy combined with task-oriented training on limb function recovery in stroke patients with hemiplegia. A total of 304 older patients with post-stroke hemiplegia who received treatment in Nanyang Third People's Hospital between March 2020 and March 2022 were enrolled as the subjects. They were assigned to the intervention group and the control group through a systematic randomization method, with 152 patients in each group. The control group was treated with conventional medication and task-oriented training, while the intervention group received a combined mirror therapy in addition to the treatment given to the control group. Both groups received continuous treatment for 3 months. The pre-treatment findings and those obtained after 3 month of treatment were compared between the two groups in the following areas, the neurological functions, including the levels of neuron-specific enolase (NSE) and S100β, a central nervous system specific protein, upper and lower limb motor function as reflected by Fugl-Meyer Assessment (FMA) score, balance ability as measured by Berg Balance Scale (BBS), and the integrated electromyography (iEMG) values of quadriceps femoris, gastrocnemius, and tibialis anterior muscles, three-dimensional gait spatiotemporal parameters, and quality of life as reflected by the assessment results for the National Institute of Stroke Scale (NIHSS) and Stroke-Specific Quality of Life Scale (SS-QOL). The findings were compared to identify changes. After 3 months of treatment, the FMA and BBS scores and three-dimensional gait spatio-temporal parameters in the intervention group were significantly better than those in the control group (all P<0.05). Mirror therapy combined with task-oriented training promotes the function recovery of the affected limbs in older patients with post-stroke hemiplegia, effectively improves their motor function and quality of life, and helps improve patient prognosis.

Corrigendum: Translation and adaptation of the stroke-specific quality of life scale into Swahili

No abstract available.

Comparative Study On Quality of Life Between Thrombolysed and Non-Thrombolysed Ischemic Stroke Patients

Stroke is one of the leading causes of morbidity and mortality worldwide. Ischemic strokes are the most common variety of strokes caused by either thrombosis or embolism. In addition, they account for 50% – 85% of cerebrovascular accidents. Thrombolysis is used in the treatment of acute ischemic stroke. The current study examined the clinical profile and assessed risk factors, adverse events, and quality of life between thrombolytic and non-thrombotic ischemic stroke patients. A prospective observational study was conducted in a tertiary care Hospital with a sample size of 106 Ischemic stroke patients for four months. The patients were enrolled based on inclusion and exclusion criteria and were interviewed using a semi-structured questionnaire. Quality of life was assessed using Stroke specific quality of life scale (SSQOL). The results showed that the incidence of stroke is most common in the age group of 61-80 years, with a mean age of 59.9 years. Hypertension was the leading risk factor in 74.4% of cases. Speech Involvement (74.5%) was the most common presentation, followed by Hemiparesis, Altered sensorium. In our study, patients presenting to hospital &gt;4.5hrs were higher, and the quality of life between thrombolysis and non-thrombolysis patients were nearly identical. However, there was applied statistically significant distinction in energy, mobility, self-care, vision, and work items of the SSQoL scale. We conclude that the two groups had no major variations within the primary outcome of QOL. Thus, the current study tends to expect that patients with non-thrombolytic therapy will have a worse quality of life due to the greater initial stroke severity. Therefore, medical care appears to be of more importance in achieving a higher quality of life in ischemic thrombolysis stroke patients who reply to this therapy.

Effect of Endurance Training on Long-Term Stroke Survivors

Background: Stroke is one of the leading causes of dependency and mortality in India. Chronic stroke is defined as 6 months to years from the time of onset. Structural impairment which occurs in stroke lead to the complex nature of functional limitations. High blood pressure, diabetes mellitus, blood vessel diseases, and obesity are a few risk factors that can cause stroke. Once the patient goes into the chronic phase, a wide range of problems in functional mobility, gait, and Quality of Life may occur. Majority of times the patient survives their remaining life with these disabilities. The survival rate decreases with an increase in time. Only 1% survive 20 years after stroke. Physiotherapy has shown a positive effect on functional outcomes in acute stroke. Its efficacy should be tried on chronic survivors. Method: 36 subjects were included as per the inclusion and exclusion criteria. The treatment protocol was given for 42 days. Pre and post-changes in subjects were analyzed on a modified Barthel index and stroke-specific Quality of Life scale. Result: Data was analyzed using the student’s t-test. Findings showed significant change in outcome measures interns of mobility and quality. Conclusion: Endurance training improves functional mobility and standard of living in chronic stroke survivors.

Effect of the physical rehabilitation program based on self-care ability in patients with acute ischemic stroke: a quasi-experimental study

IntroductionIt is the most practical goal of limb rehabilitation for stroke patients to make the upper limb, trunk, and lower limb joints link together as a whole and restore the ability to self-care. However, many previous studies focused on the single joint or single muscle group movement of stroke patients and did not integrate self-care ability training into the whole process of rehabilitation, which lacks accuracy, integrity, and systematization.MethodsA quasi-experimental study was conducted in a tertiary hospital. Eligible patients were recruited according to the inclusion criteria and exclusion criteria and then divided into an experimental group (n = 80) and a control group (n = 80) by the medical district. The control group received the routine physical rehabilitation intervention. The experimental group adopted the physical rehabilitation program based on self-care ability led by the nurses specializing in stroke rehabilitation to carry out the multi-joint coordinated exercise based on the control group. The training time and frequency were the same in both groups (45 min per session, one session per day for three consecutive months). The primary outcome was myodynamia. Secondary outcomes were the modified Barthel Index (MBI) and Stroke Specific Quality of Life Scale (SS-QOL). The primary and secondary outcomes were assessed before the intervention and at 1 and 3 months of intervention. In this study, the TREND checklist was followed for non-randomized controlled trials.ResultsA total of 160 participants completed the study. The physical rehabilitation program based on self-care ability was better than the routine rehabilitation program. With the prolongation of intervention time, all outcomes improved gradually in the experimental group (P &amp;lt; 0.05), and the myodynamia of lower limbs recovered faster than that of upper limbs. In the control group, the myodynamia of the affected limb was not significantly improved (P &amp;gt; 0.05), with only a small increase in MBI and SS-QOL scores (P &amp;lt; 0.05).ConclusionThe physical rehabilitation program based on self-care ability after stroke was beneficial for acute ischemic stroke patients and improved the patient's myodynamia, quality of life, and self-care ability within the third month.

Gait Device Treatment Using Telehealth for Individuals With Stroke During the COVID-19 Pandemic: Nonrandomized Pilot Feasibility Study.

During the COVID-19 pandemic, rehabilitation providers and consumers adopted telehealth practices at unprecedented rates. Multiple prepandemic studies demonstrate the feasibility and comparable efficacy between in-clinic and remote treatment for certain impairments caused by stroke, such as upper extremity weakness and impaired motor function. However, less guidance has been available regarding gait assessment and treatment. Despite this limitation, safe and effective gait treatment is fundamental to optimizing health and well-being after stroke and should be considered a treatment priority, including during the COVID-19 pandemic. This study explores the feasibility of using telehealth to deliver gait treatment using a wearable gait device, the iStride device, to stroke survivors during the 2020 pandemic. The gait device is used to treat hemiparetic gait impairments caused by stroke. The device alters the user's gait mechanics and creates a subtle destabilization of the nonparetic limb; therefore, supervision is required during its usage. Before the pandemic, treatment with the gait device had been provided in person to appropriate candidates using a combination of physical therapists and trained personnel. However, upon the emergence of the COVID-19 pandemic, in-person treatment was halted in adherence to pandemic guidelines. This study investigates the feasibility of 2 remote delivery treatment models with the gait device for stroke survivors. Participants were recruited during the first half of 2020 after the onset of the pandemic and included 5 individuals with chronic stroke (mean age 72 years; 84 months post stroke). Four participants were previous gait device users who transitioned to the telehealth delivery model to continue their gait treatment remotely. The fifth participant performed all study-related activities, from recruitment through follow-up, remotely. The protocol included virtual training for the at-home care partner, followed by 3 months of remote treatment with the gait device. Participants were instructed to wear gait sensors during all treatment activities. To assess feasibility, we monitored the safety of the remote treatment, compliance with protocol activities, acceptability of the telehealth treatment delivery, and preliminary efficacy of the gait treatment. Functional improvement was measured using the 10-Meter Walk Test, the Timed Up and Go Test, and the 6-Minute Walk Test, and quality of life was assessed using the Stroke-Specific Quality of Life Scale. No serious adverse events occurred, and participants rated high acceptance of the telehealth delivery. Protocol compliance averaged 95% of treatment sessions, 100% of assessments, and 85% of sensor usage during treatment. After 3 months of treatment, the average improvement in each functional outcome exceeded the minimal clinically important difference or minimal detectable change value. Remote treatment delivery with the gait device appeared feasible with care partner support. Gait treatment using telehealth may be useful to offset negative immobility impacts for those requiring or preferring remote care during the pandemic or otherwise. ClinicalTrials.gov NCT04434313; https://clinicaltrials.gov/ct2/show/NCT04434313.

Translation and adaptation of the stroke-specific quality of life scale into Swahili.

Stroke care requires a patient-centred, evidence-based and culturally appropriate approach for better patient clinical outcomes. Quality of life necessitates precise measuring using health-related quality measures that are self-reported and language appropriate. However, most of the self-reported measures were devised in Europe and therefore not considered contextually appropriate in other settings, more so in Africa. Our study aimed to produce a Swahili version by translating and adapting the stroke-specific quality of life (SSQOL) scale among people with stroke in Kenya. We used a questionnaire translation and cross-cultural adaptation. The pre-validation sample of 36 adult participants was drawn from 40 registered people with stroke, from the Stroke Association of Kenya (SAoK). Quantitative data were collected using both English and Swahili versions of the SSQOL scale. The mean, standard deviation (s.d.) and overall scores were calculated and are presented in tables. The back translation revealed a few inconsistencies. Minor semantic and equivalence alterations were done in the vision, mood, self-care, upper extremity function and mobility domains by the expert review committee. Respondents indicated that all questions were well-understood and captured. The stroke onset mean age was 53.69 years and the standard deviation was 14.05. The translated version of the Swahili SSQOL questionnaire is comprehensible and well-adapted to the Swahili-speaking population. The SSQOL has the potential to be a useful outcome measure for use in Swahili-speaking patients with stroke.

Reliability and validity of Stroke specific quality of life Urdu version - A preliminary approach

Aim: To measure reliability, validity, and psychometric properties of Urdu version of Stroke-Specific Quality of Life scale. Methodology: A longitudinal cross-sectional observational survey was conducted from March 2019 to February 2020. The sample size was calculated by using Rao soft and non-probability convenient sampling technique was used to raise the sample. For translation purpose, the original English version of SSQOL was translated into Urdu by National Language Promotion Department, Govt. of Pakistan.96 stroke survivors filled the final SSQOL Urdu version twice within seven-day period. Data was analyzed by using Spearman and Pearson correlation, Cronbach’s alpha, Intra-class Correlation Coefficient (ICC) at their threshold values, independent t-test, and One-way ANOVA at p &lt; 0.05. Results: The SSQOL-U exhibited acceptable to excellent internal consistency with Cronbach’s alpha= 0.943 with ICC= 0.84-0.93. In comparison ceilings effects were higher than floor effects. Results also established high test-retest reliability in all domains had Spearman’s rho scores &gt;0.8 except for Energy, family, and Mood. An acceptable item to scale correlation convergent validity with rp values ranged between 0.81–0.97. Practical Implication: The SSQOL-U will be utilized by practitioners and researchers across the country to accurately measure patient reported quality of life in post stroke patients. Conclusion: SS-QOL-U showed adequate psychometric properties. SS-QOL-U was found reliable and valid tool to measure the quality of life in Urdu-speaking patients having subacute and chronic stroke. Key words: Stroke, validity, reliability, Stroke specific quality of life

Visual Problems are Associated with Long-Term Fatigue after Stroke

Post-stroke fatigue may be associated with functioning even in patients with mild stroke. In order to guide rehabilitation, the aim of this study was to investigate the independent contribution of 12 function-related domains to severe long-term fatigue. Observational follow-up study. A total of 144 stroke survivors (mean age 67.3, standard deviation (SD) 10.9 years) were included. Fatigue 3-4 years post-stroke was measured with the Fatigue Severity Scale (cut-off ≥5). Independent variables were the multidimensional Stroke-Specific Quality of Life scale with 12 domains, demographics, and baseline stroke characteristics. Most of the participants had mild and moderate stroke. Thirty-five percent (n = 51) reported severe fatigue 3-4 years after stroke. Those living with a significant other, and working participants reported significantly less fatigue. All domains of the Stroke-specific Quality of Life scale were significantly associated with the Fatigue Severity Scale. Adjusted for age, sex, marital status, and work status, the domains "energy", "mood", and, unexpectedly, the domain "vision", were all variables independently associated with severe long-term fatigue. Stroke survivors with prominent self-reported visual problems were more likely to experience fatigue. This finding should be verified in further studies. Visual examination and visual rehabilitation may reduce fatigue in selected stroke survivors.

The effect of robot-assisted gait training frequency on walking, functional recovery, and quality of life in patients with stroke.

This study aims to investigate the effects of robot-assisted gait training (RAGT) frequency on walking, functional recovery, QoL and mood. Sixty patients aged 50-75, diagnosed with post-stroke hemiplegia were entered into the retrospective analysis. Participants who scored maximum 3 on the Modified Rankin Scale and were diagnosed with moderate stroke according to The NIH Stroke Scale were included in the study. The participants in group 1 (G1) received only conventional treatment (CT), in group 2 (G2) participants received one session of RAGT per week in addition to the CT program, and group 3 (G3) received two sessions of RAGT per week in addition to the CT program. 6-min walk test (6-MWT), Barthel Index (BI), Stroke-Specific Quality of Life Scale (SSQoL), and Beck Depression Inventory (BDI) were recorded. Median change in SSQoL of G3 was significantly higher from median change of G1 (p < 0.05), and median change in BDI of G3 was significantly lower than median change of G1 (p < 0.05). Median change in BDI of G3 was also significantly lower from change of G2 (p < 0.05). Two weekly sessions of RAGT in addition to CT exhibit positive effects on QoL and mood but no additional contribution to functional status.

Psychometric properties of the 12-item Stroke-Specific Quality of Life Scale among stroke survivors in Hong Kong

The present study examined the psychometric properties of the 12-item Stroke-Specific Quality of Life Scale (SSQOL-12) in 184 stroke survivors in Hong Kong. The participants completed a self-report questionnaire including the SSQOL-12, SF-12 health survey, and validating variables at baseline and 148 stroke survivors completed SSQOL-12 two months later. Confirmatory factor analysis investigated the construct validity, reliability, and measurement invariance of SSQOL-12 across two months. Concurrent, convergent, and divergent validity was examined with respect to SF-12, hope, self-esteem, functional disability, anxiety, and depression. The original 2-factor model did not reveal a superior fit over the 1-factor model and a modified 1-factor model provided an acceptable fit to the data in both waves. The SSQOL-12 factor displayed substantial factor loadings (λ = 0.40–0.87), good internal consistency (Ω = 0.88), temporal stability (r = 0.70), and scalar measurement invariance across time. Stroke-specific quality of life was significantly associated with higher levels of SF-12, hope, and self-esteem and lower levels of functional disability, anxiety, and depression. Most correlations remained significant after controlling for demographic covariates and SF-12. The present findings offered empirical support for the validity and reliability of the unidimensional structure for SSQOL-12 as a measure of stroke-specific quality of life among stroke survivors.

Cross-cultural translation, adaptation, and validation of the stroke-specific quality of life (SSQOL) scale 2.0 into Amharic language

BackgroundThe stroke-specific quality of life 2.0 (SSQOL 2.0) scale is a valid, reliable instrument which has been widely used as a patients reported outcome measure among stroke survivors. However, the SSQOL scale has not been validated and used in any Ethiopian language. This study aimed to translate, culturally adapt, and test the psychometric properties of the SSQOL scale 2.0 in Amharic, which is the official and working language with about 34 million (23%) speakers in Ethiopia.MethodsThe adapted English version of the SSQOL 2.0 scale was translated into Amharic and then back-translated to English. An expert committee translated and created a final Amharic version of SSQOL (SSQOL-AM) scale. Pre-field testing (pilot and cognitive debriefing) was conducted with 15 post-stroke subjects. The SSQOL-Am was administered to 245 stroke survivors from four referral hospitals to determine the psychometric properties. Cronbach’s alpha and Intra-class correlation coefficient were used to calculate the internal consistency and test–retest reliability, spearman’s correlation for the convergent validity of the SSQOL-Am scale. The Standard Error of Measurement (SEM), Minimum Detectable Change (MDC), Bland Altman Limit of Agreement (LOA), Confirmatory Factor Analysis, and Exploratory Factor Analysis were also determined.ResultsThe SSQOL-Am demonstrated excellent test–retest reliability (ICC = 0.93), internal consistency (Cronbach’s alpha = 0.96), SEM 0.857, MDC 1.94, and good LOA. As postulated, the mobility domain of the tool demonstrated a significantly strong correlation with the physical function domain of the SF-36 (rho = 0.70, p < 0.001).ConclusionsThe SSQOL-Am is a valid and reliable outcome measure. The tool can be used in both clinical practice and research purposes with Amharic speaking post-stroke survivors.

The concurrent validity of the Stroke Self-Efficacy Questionnaire Brazil (SSEQ-B) in brazilian stroke survivors

The Stroke Self-Efficacy Questionnaire Brazil (SSEQ-B) is designed to assess the self-efficacy of functional performance after stroke. Objective: To evaluate the concurrent validity of the SSEQ-B in Brazilian stroke survivors in relation to gold-standard measures of instrumental and basic daily living activities as well as quality of life after stroke. Methods: The concurrent validity of the SSEQ-B was tested using the Frenchay Activity Index (FAI), Barthel Index (BI) and Stroke Specific Quality of Life Scale (SS-QOL). Descriptive statistics, the Spearman’s coefficient index, Intraclass correlation coefficient (ICC), Cronbach alpha and achieved post-hoc power (1-ß) analyses were conducted. Results: Seventy-five stroke survivors aged 66.64 ± 12.97 years were included in this study. Total scores from the SSEQ-B were strongly correlated with the FAI (ICC= 0.8 / r= 0.72 / 1-ß= 1.0) and BI (ICC= 0.68 / r= 0.68 / 1-ß= 0.99), but weakly correlated with SS-QOL (ICC= 0.46 / r= 0.65 / 1-ß= 0.94), which suggests stroke self-efficacy is more closely associated with instrumental and daily living activities than the quality of life. Conclusion: The SSEQ-B exhibits good concurrent validity with instrumental and daily living activities and could be useful when assessing stroke self-efficacy in Brazilians.

Construction and Validation of the 17-Item Stroke-Specific Quality of Life Scale (SS-QOL-17): A Comprehensive Short Scale to Assess the Functional, Psychosocial, and Therapeutic Factors of QOL among Stroke Survivors.

(1) Background: The exiting stroke-specific quality of life (SS-QOL) measure scales are limited by their excessive length, inconsistent validity, and restricted breadths of assessment. The objectives of this study were to construct and validate a comprehensive short SS-QOL scale to assess stroke-related outcomes and QOL and determine the socioeconomic, sociodemographic, and pharmacotherapeutic predictors of QOL among stroke survivors. (2) Methods: The novel 17-item SS-QOL scale (SS-QOL-17) was constructed with the aim of providing a well-balanced measuring tool to depict QOL widely while ensuring the simplicity of administration. (3) Results: The SS-QOL-17 structure was validated over a solution of three factors with a Kaiser-Meyer-Olkin measure of sampling adequacy = 0.894 and a significant Bartlett's test of sphericity (p &lt; 0.001). The Cronbach's alpha of the SS-QOL-17 was 0.903. Better QOL was correlated to financial wellbeing (beta 0.093, p &lt; 0.001), and medication adherence (beta 0.305, p = 0.004), whereas reduced QOL was correlated to older age (beta -0.117, p = 0.014), illiteracy (beta -6.428, p &lt; 0.001), unemployment (beta -6.170, p &lt; 0.001), and higher amount of prescribed medication (beta -1.148, p &lt; 0.001). (4) Conclusions: The SS-QOL-17 is a valid and reliable tool with promising psychometric properties. It is useful in clinical practice and research settings to evaluate the post-stroke therapeutic and rehabilitation outcomes.

Virtual reality and serious game therapy for post-stroke individuals: A preliminary study with humanized rehabilitation approach protocol

ObjectiveThe current study proposed the development and preliminary validation of a humanized training approach for upper limb rehabilitation of chronic post-stroke individuals, using serious game (SG) and virtual reality (VR) technologies. Materials and methodsTen individuals with chronic stroke participated in the study. Accompanied by a health professional, 15 sessions of the SG were performed in a laboratory, in a humanized way, lasting between 30 and 45 min each. The assessments were made pre- and post-intervention with the SG, and the following parameters were evaluated (considering the elbow joint): Modified Ashworth Scale (MAS), range of movement (ROM) and tonic stretch reflex threshold (TSRT). Global measures such as quality of life (QOL) were also assessed by the Stroke-Specific Quality of Life Scale (SSQL), Brunnstrom Recovery Scale (BRS) and General Health Questionnaire (GHQ-28). The following tests were applied to verify statistically significant differences: Shapiro-Wilk test, t-test, and Wilcoxon-Mann-Whitney test. ResultsThe parameters ROM, TSRT, BRS, and SSQL showed statistically significant differences between pre- and post-intervention (p < 0.01). The ROM increase was about 8%. The objective evaluation of spasticity (provided by the TRST) showed an increase of 28% over the average pre- and post-intervention values. Three participants showed decreased resistance to passive stretching according to the results of the MAS, and seven participants moved to the next stage of the BRS. For QOL, the scores indicated around 20% of post-intervention improvement. ConclusionThe intervention had no adverse effects, showed a high degree of compliance, provided increased ROM, improved QOL, reduced spasticity and allowed these individuals the opportunity to test a promising technology for upper limb rehabilitation with emphasis in humanized aspects of therapy.

Outcomes in the Year After First-Ever Ischemic Stroke in a Bi-Ethnic Population.

To investigate stroke outcomes at 3, 6, and 12months post-stroke overall and by ethnicity in a population-based, longitudinal study. First-ever ischemic strokes (2014-2019, n=1,332) among Mexican American persons (n=807) and non-Hispanic white persons (n=525) were identified from the Brain Attack Surveillance in Corpus Christi Project. Data were collected from patient or proxy interviews (baseline, 3, 6, and 12months post-stroke) and medical records, including functional (activities of daily living/instrumental activities of daily living score), neurological (National Institutes of Health Stroke Scale), cognitive (Modified Mini-Mental State Examination), and quality of life (QOL) outcomes (12-domain Stroke-specific Quality of Life scale). Outcome trajectories were analyzed using multivariable adjusted linear models, with generalized estimating equations to account for within-subject correlations; interactions between ethnicity and time were included to investigate ethnic differences in outcomes. The median age was 67 years (interquartile range 58,78), 48.5% were women, and 60.6% were Mexican American persons. For all outcomes, significant improvement was seen between 3 and 6 months (p< 0.05 for all), with stability between 6 and 12months. Mexican American persons had significantly worse outcomes compared with non-Hispanic white persons at all time points (3, 6, and 12months), with the exception of the National Institutes of Health Stroke Scale, which did not differ by ethnicity at 6 and 12months, and the average change in outcomes did not vary significantly by ethnicity. Outcomes were at their worst at 3 months post-stroke, and ethnic disparities were already present, suggesting the need for early assessment and strategies to improve outcomes and possibly reduce disparities. ANN NEUROL 2023;93:348-356.

Effect of the combination of cognitive behavioral therapy and oral paroxetine hydrochloride in patients with post-stroke depression

Purpose: To determine the effects of combined use of cognitive behavioral therapy (CBT) and paroxetine hydrochloride tablets in patients with post-stroke depression (PSD), and its effect on scores on Hamilton Rating Scale for Depression (HAMD) and Stroke Specific Quality of Life Scale (SS-QOL).&#x0D; Methods: Clinical data for 96 patients with PSD who were treated in Dongying Traditional Chinese Hospital, Dongying City, China from June 2018 to June 2019 were retrospectively analyzed. Patients who met the inclusion criteria were divided into treatment group (TG, n = 48) and reference group (RG, n = 48) based on odd and even hospitalization numbers. Both groups received conventional treatment, but RG patients were in addition given clopidogrel, while TG received CBT in combination with paroxetine hydrochloride tablets. Clinical indices were evaluated in both groups before and after treatment. Moreover, therapeutic effects in the two different treatment methods on PSD, as well as on Hamilton Rating Scale for Depression (HAMD) and Stroke Specific Quality of Life Scale (SS-QOL) scores were analyzed.&#x0D; Results: After treatment, TG had lower HAMD score (p &lt; 0.001), lower scores on modified Rankin scale, and few incidences of adverse reactions at 3, 7, 15 and 30 days of treatment (p &lt; 0.05), but higher total clinical effectiveness and mean SS-QOL score (p &lt; 0.05), when compared with RG.&#x0D; Conclusion: Combined use of CBT and oral paroxetine hydrochloride tablets may be a promising strategy for treating depression and enhancing the quality of life of PSD patients, as it greatly improves neurological deficit and prognosis. However, further clinical trials should be carried out prior to introducing it in clinical practice.

Assessment of quality of life of stroke survivors and their caregivers presenting to a tertiary care hospital in Pakistan.

To determine the quality of life of stroke survivors and their caregivers presenting to a tertiary care setup. The descriptive study was conducted from July to December 2019 at the Neurology Department, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, and comprised patients of either gender with ischaemic or haemorrhagic stroke aged 40-70 years and their caregivers. Data was collected using the stroke-specific quality of life Scale and the caregiver quality of life questionnaire. Data was analysed using SPSS 20. Of the 80 patients, 50(62.5%) were males and 30(37.5%) were females. The overall mean age was 61.46±11.80 years, and 56(70%) were aged >55 years. Among the patients, speaking power, mobility and mood were more affected with mean levels of 15.51±8.63, 22.63±8.33 and 19.08±7.05, respectively. The domains of social role, self-care and upper extremity function were also affected with mean values of 19.022±7.06, 15.71±8.81 and 18.88±7.02, respectively. Among the caregivers, the levels of physical wellbeing and functional wellbeing were high 15.07±5.65 and 15.35±5.76, respectively. There were differences in terms of age and gender but the difference was not significant (p>0.05). The quality of life of stroke survivors was low, and that of caregivers was also quite compromised.