Stroke Specific Quality Of Life Scale Research Articles

The Reliability and Validity of the Korean Short Version of the Stroke-Specific Quality of Life Scale.

The aim of this study was to assess the reliability and validity of the Korean short version of the Stroke-Specific Quality of Life Scale (SS-QoL-12K). A descriptive, cross-sectional design was used. We recruited 233 outpatients with ischemic stroke. The Cronbach's alpha coefficients for internal consistency was .93, and the test-retest reliability value was .98. Confirmatory factor analysis identified two dimensions for the SS-QoL-12K. The SS-QoL-12K was correlated positively with the 36-Item Short Form Health Survey score and Instrumental Activities of Daily Living and negatively with the modified Rankin Scale score. The SS-QoL scores in the National Institutes of Health Stroke Scale mild group were higher than those in the National Institutes of Health Stroke Scale moderate and severe groups. This study shows that the SS-QoL-12K has a satisfactory level of reliability and validity in patients with ischemic stroke. This instrument will be helpful in advancing research and clinical care for stroke patients.

Cough Effectiveness, Functional Independence and Quality of Life of Stroke Survivors: A Cross-sectional Survey

Background: Stroke is associated with clinical spectrum of respiratory impairments, a significant one being aspiration pneumonia owing to failure to safeguard and clear the airway through coughing. Objectives: This research evaluated the correlation among cough effectiveness, functional independence, and quality of life of stroke survivors. Methods: This study involved 33 stroke survivors (13 males and 20 females) aged between 39-80 years. They were recruited from a teaching hospital in Nigeria. The participants were recruited between April and October, 2018. Cough effectiveness, functional independence (FI) and perception of quality of life (QoL) were assessed using Peak flow meter, Functional Independence Measure (FIM) and Stroke Specific Quality of Life Scale (SS-QoL) respectively. Spearman rank correlation coefficient was used to obtain the relationship between measured parameters. Level of significance was set at p<0.05. Results: The mean peak cough flow (PCF) was 195.75±51.90 L/min for all the study participants. There was a positive significant correlation between cough effectiveness and motor subunit of FIM (rs=0.530, p=0.002) and overall FIM (rs=0.484, p=0.004). There was also a positive significant correlation between cough effectiveness and overall QoL score (rs=0.517, p=0.002). Five domains of QoL showed positive significant correlation to cough effectiveness; these include Mobility (rs=0.524, p=0.002), Self-care (rs=0.448, p=0.009), Social role (rs=0.487, p=0.004), Upper-limb function (rs=0.535, p=0.001), and Work and productivity (rs=0.556, p=0.001). Conclusion: Cough effectiveness is significantly positively correlated to functional independence and the QoL of stroke survivors.

Dual-Task Exercise Reduces Cognitive-Motor Interference in Walking and Falls After Stroke.

Background and Purpose- Functional community ambulation requires the ability to perform mobility and cognitive task simultaneously (dual-tasking). This single-blinded randomized controlled study aimed to examine the effects of dual-task exercise in chronic stroke patients. Methods- Eighty-four chronic stroke patients (24 women; age, 61.2±6.4 years; time since stroke onset, 75.3±64.9 months) with mild to moderate motor impairment (Chedoke-McMaster leg motor score: median, 5; interquartile range, 4-6) were randomly allocated to the dual-task balance/mobility training group, single-task balance/mobility group, or upper-limb exercise (control) group. Each group exercised for three 60-minute sessions per week for 8 weeks. The dual-task interference effect was measured for the time to completion of 3 mobility tests (forward walking, timed-up-and-go, and obstacle crossing) and for the correct response rate during serial-3-subtractions and verbal fluency task. Secondary outcomes included the Activities-specific Balance Confidence Scale, Frenchay Activities Index, and Stroke-specific Quality of Life Scale. The above outcomes were measured at baseline, immediately after, and 8 weeks after training. Fall incidence was recorded for a 6-month period posttraining. Results- Only the dual-task group exhibited reduced dual-task interference in walking time posttraining (forward walking combined with verbal fluency [9.5%, P=0.014], forward walking with serial-3-subtractions [9.6%, P=0.035], and the timed-up-and-go with verbal fluency [16.8%, P=0.001]). The improvements in dual-task walking were largely maintained at the 8-week follow-up. The dual-task cognitive performance showed no significant changes. The dual-task program reduced the risk of falls and injurious falls by 25.0% (95% CI, 3.1%-46.9%; P=0.037) and 22.2% (95% CI, 4.0%-38.4%; P=0.023), respectively, during the 6-month follow-up period compared with controls. There was no significant effect on other secondary outcomes ( P>0.05). Conclusions- The dual-task program was effective in improving dual-task mobility, reducing falls and fall-related injuries in ambulatory chronic stroke patients with intact cognition. It had no significant effect on activity participation or quality of life. Clinical trial registration- URL: https://www.clinicaltrials.gov . Unique identifier: NCT02270398.

Evaluation of the effect of balance training in hemiplegic patients

Aim of the work: To assess the postural instability in hemiplegic patient and evaluate the effect of balance training by the biodex balance system (BBS-SD). Patients and methods: Forty patients with hemiplegia (hemiplegic group) and 30 healthy volunteers (control group). The hemiplegic group was subdivided randomly into two subgroupsnI and IInaccording to the rehabilitation program. Group, I received balance training by BSS-SD in addition to traditional rehabilitation program for hemiplegia. Group II received a traditional rehabilitation program for hemiplegia. All patients were functionally assessed by Stroke Specific Quality of life scale (Ss-QOL) scale and balance assessment by berg balance scale and by using BSS-SD. Results: There was significant affection of overall stability index of postural stability test, fall risk test and parameters of limits of stability (LOS)test in hemiplegic group in comparison to the apparently control group (p ≤ 0.05 ). There was a statistically significant improvement in both hemiplegic subgroups but more significant in group I regarding postural stability test, fall risk test and limits of stability test. Also, there was an improvement in Ss-QOL scale and BBS that was more significant in group I. Conclusions: Stroke patients have postural instability and increased risk of falling. Balance training by using BSS-SD in addition to the traditional rehabilitation program decreases the postural instability, also improves the quality of life more than the traditional rehabilitation program only.

Clinical observation on Wang Juyi's applied channel theory in treating stroke-sequel patients

OBJECTIVETo explore the advantages of acupuncture treatment guided by channel palpation on stroke-sequel patients. METHODSThis research was randomized, traditional acupuncture controlled trial using channel palpation acupuncture to treat stroke-sequel patients. Totally 148 patients who were randomly assigned to two experimental groups. The treatment group, i.e, the channel palpation group was treated with Dr. Wang Juyi's Channel Palpation. Patients in control group received acupuncture according to New Century Acupuncture. Every patient was needled at Renzhong (GV 26), Baihui (GV 20), Neiguan (PC 6), Jiquan (HT 1), Chize (LU 5), Weizhong (BL 40), Sanyinjiao (SP 6), Zusanli (ST 36), and each acupuncture treatment was modified according different syndrome differentiations including liver yang rising [Taichong (LR 3), Taixi (KI 3)], wind-phlegm blocking collaterals [Fenglong (ST 40), Hegu (LI 4)], phlegm-heat occupying in the Fu-organs [Quchi (LI 11), Neiting (ST 44), Fenglong (ST 40)], Qi deficiency with blood stasis [Qihai (CV 6), Xuehai (SP 10)], Yin Deficiency with wind [Taixi (KI 3), Fengchi (GB 20)]; for wry mouth, add Jiache (ST 6), Dicang (ST 4); for paralyzed arms, add Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10) and Hegu (LI 4), for paralyzed legs, add Huantiao (GB 30), Yinlingquan (SP 9) and Fengshi (GB 31). The duration of each treatment was 6 weeks. Then the Fugl-Meyer score, the Stroke Specific Quality of Life scale (SS-QOL), and the National Institute of Health Stroke Scale (NIHSS) were assessed before treatments, after 6 and 12 weeks of treatments to evaluate the acupuncture effect in each group. The data were collected and analyzed after the completion of treatment by SPSS 17 using paired sample t-test. RESULTSTotally 148 participants were recruited, and 136 eligible patients were included in this study. The results showed that for FMA motor function and Fugl-Meyer balance function and NIHSS, there is no statistic difference between two groups at the baseline period, after 6-week treatment and after 12-week follow-up (P > 0.05); However, for NIHSS and SS-QOL, there is no statistic difference between two groups at the baseline period and 6 weeks after treatment (P > 0.05). However, statistical difference starts to appear after 12-week (P = 0.028, 0.037 < 0.05). CONCLUSIONWe conclude that as for improving the nerve function and the quality of life, Dr. Wang Juyi's Applied Channel Theory presents a better clinical result.

Effect of warm joint needling plus rehabilitation on the balance function and quality of life of patients with spastic hemiplegia after ischemic cerebral stroke

To observe the effect of warm joint needling plus rehabilitation techniques on the balance function and quality of life (QOL) of patients with spastic hemiplegia after ischemic cerebral stroke. Ninety patients with spastic hemiplegia after ischemic cerebral stroke were randomized into a rehabilitation group, a warm joint needling group and an observation group, with 30 cases in each group. The rehabilitation group was intervened by Bobath therapy, the warm joint needling group was treated with joint needling on the affected side plus warm needling, and the observation group was given the same rehabilitation treatment as the rehabilitation group together with the same warm joint needling as the warm joint needling group. The three groups were treated once another day, 1 month as a treatment course for 6 months. Before the treatment, and respectively after 2-week, 1-month, 3-month, and 6-month treatment, the modified Ashworth scale (MAS) was used to measure the anti-spasm ability of the lower limb, the Berg balance scale (BBS) was adopted to evaluate the balance function, and the stroke-specific quality of life scale (SS-QOL) was employed to estimate the QOL. After 3-month and 6-month treatment, the lower-limb MAS scores in the observation group were significantly better than those in the rehabilitation group and the warm joint needling group (all P<0.05). After 1-month, 3-month and 6-month treatment, the BBS scores in the observation group were significantly better than those in the rehabilitation group and the warm joint needling group (all P<0.05). After 2-week, 1-month, 3-month and 6-month treatment, the SS-QOL scores in the observation group were markedly better than those in the rehabilitation group and the warm joint needling group (all P<0.05). Warm joint needling plus rehabilitation can effectively improve the lower‐limb spasticity state, balance function and QOL in patients with spastic hemiplegia after ischemic cerebral stroke.

Quality of Life Assessment in Post-Stroke Patients

Abstract Aim. Presentation of quality of life of post-stroke patients treated in the Neurology Ward of the District Specialist Hospital. Material and methods. The research covered 80 patients after stroke, treated in the Neurology Ward of the District Specialist Hospital. The study used the diagnostic survey method, the questionnaire technique and the standardized research tool: the Polish version of the Stroke-Specific Quality of Life Scale (SS-QOL), authored by Williams et al. The scale comprised 12 subscales and an overall result, all of which ranged between 1 and 5 points. Higher scores corresponded to higher quality of life. Differences between the variables were verified with nonparametric tests. The significance level was established at p&lt;0.05. Results. Quality of life of post-stroke patients treated in the Neurology Ward of the District Specialist Hospital was at the level of 2.64, that is below the average established in the middle of the 1-5 scale. The overall quality of life was higher among women (3.02) than among men (2.39). Patients after ischemic stroke had significantly higher quality of life (at the level of 2.83) than patients after hemorrhagic stroke (at 2.23). Conclusions. The problem of patients after stroke is not only limitation of mobility due to paresis. Identification of bio-psycho-social disorders and help in overcoming them can radically change the patient’s situation. The assessment of quality of life is an indispensable task because it enables evaluation of the patient’s condition, not only in terms of effectiveness of therapy, but above all, in terms of a possibility for improvement of the patient’s quality of functioning, in the mental and social aspects.

Efficiency of Neuromuscular Electrical Stimulation and Transcutaneous Nerve Stimulation on Hemiplegic Shoulder Pain: A Randomized Controlled Trial

ObjectiveTo compare the efficacy of neuromuscular electrical stimulation (NMES) and transcutaneous nerve stimulation (TENS) on hemiplegic shoulder pain (HSP). DesignThis is a prospective randomized controlled trial. SettingA rehabilitation hospital. ParticipantsParticipants (N=90) were randomized into NMES (n=36), TENS (n=36), or control groups (n=18). InterventionsNMES (15Hz, pulse width 200μs) was applied to supraspinatus and deltoids (medial and posterior parts), whereas TENS (100Hz, pulse width 100μs) was used on the same areas. The surface electrodes were placed near the motor points of the supraspinatus and medial or posterior bundle of deltoids. The 4-week treatment consisted of 20 sessions, each session composed of 1 hour of stimulation per day. Routine rehabilitation program without any stimulation was administered to the control and the NMES/TENS groups. Numerical rating scale (NRS), active/passive range of motion (AROM/PROM) of shoulder, upper extremity Fugl-Meyer Assessment (FMA), modified Ashworth scale (MAS), Barthel Index (BI), and stroke-specific quality of life scale (SSQOLS) were assessed in a blinded manner at baseline, 2, 4, and 8 weeks after treatment, respectively. Main Outcome MeasuresThe primary endpoint was the improvement from baseline in NRS for HSP at 4 weeks. ResultsNRS scores in NMES, TENS, and control groups had decreased by 2.03, 1.44, and 0.61 points, respectively after 4 weeks of treatment, with statistically significant differences among the 3 groups (P<.001). The efficacy of the NMES group was significantly better than that of the TENS group (P=.043). Moreover, the efficacy of NMES and TENS groups was superior to that of the control group (P<.001, P=.044, respectively). The differences in the therapeutic efficacy on shoulder AROM/PROM, FMA, MAS, BI, and SSQOLS scores were not significant among the 3 groups. ConclusionsTENS and NMES can effectively improve HSP, the efficacy of NMES being distinctly superior to that of TENS in maintaining long-term analgesia. However, NMES was not more efficacious than the TENS or control group in improving the shoulder joint mobility, upper limb function, spasticity, the ability of daily life activity, and stroke-specific quality of life in HSP patients.

Short- and Long-Term Efficacy of Modafinil at Improving Quality of Life in Stroke Survivors: A Post Hoc Sub Study of the Modafinil in Debilitating Fatigue After Stroke Trial.

The phase-II modafinil in debilitating fatigue after stroke trial demonstrated that modafinil improves fatigue and quality of life in severely fatigued stroke survivors. For this study, we sought to examine the interaction between fatigue and quality of life after stroke and determine whether reducing fatigue resulted in improved quality of life. In addition, we followed up a subset of patients 12-months after the trial to assess the long-term outcomes of modafinil therapy. We used linear regression to analyze interaction between baseline fatigue, as measured by the multidimensional fatigue inventory (MFI), and quality of life, as measured by the stroke-specific quality of life scale (SSQoL); and between changes in MFI and SSQoL during treatment. Patients also took part in semi-structured interviews and study assessments 12-months after trial completion to assess long-term patterns of modafinil use, safety and efficacy. MFI and SSQoL were significantly correlated at baseline (β = -1.975 95% CI -3.082, -0.869, p < 0.001), as were changes in MFI and SSQoL during treatment (β = -1.054 95% CI -1.556, -0.553, p < 0.001). 18 patients agreed to 12-month follow-up, of whom 5 had continued to use modafinil. Patients taking modafinil daily demonstrated sustained improvement of 33-38 points in MFI compared to baseline. Two adverse events were reported and there was no evidence of drug tolerance. Modafinil appears to be safe and, for at least some patients, effective long-term in fatigued stroke survivors. Alleviating fatigue has a significant relationship with improved quality of life. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368268, unique-identifier: ACTRN12615000350527.

The effect and biomechanical mechanisms of intradermal needle for post-stroke hemiplegia recovery: Study protocol for a randomized controlled pilot trial.

The incidence of stroke has increased significantly in recent years. Post-stroke hemiplegia is a common stroke complication with long-term negative consequences. Several studies have suggested that acupuncture could be an effective intervention for the rehabilitation of post-stroke hemiplegia. Intradermal needling is a kind of acupuncture which is widely used in clinical settings. This study attempts to investigate the biomechanical effects of intradermal needle for post-stroke hemiplegia recovery.This proposed study is a single-centered, prospective, single-blinded (patient-assessor-blinded), randomized clinical pilot trial involving 40 patients with post-stroke hemiplegia. Patients will be randomized to an experimental group or control group in a 1:1 ratio. All of them will receive conventional rehabilitation therapies. Patients in the experimental group will be treated with intradermal needle, whereas patients in the control group will receive sham intradermal needle. The primary outcome measures will be biomechanically validated from the parameters of RSSCAN gait system: plantar pressure distribution, step length, and stride. The scores of clinical scales such as National Institutes of Health Stroke Scale, Fugl-Meyer Assessment, Berg Balance Scale, Barthel Index, and Stroke-specific Quality of Life Scale will be assessed as secondary outcome measures. All assessments will be conducted at baseline, 4 weeks after intervention and at the end of 3 months’ follow-up.The purpose of this study is to explore the potential effect and biomechanical mechanisms of intradermal needle for post-stroke hemiplegia recovery, as well as to provide a basis for future larger clinical studies.

Quality of life among patients during subacute phase following stroke during hospitalisation period in Shanghai

Objective: This study aimed to investigate the factors influencing the quality of life of in-hospital subacute stroke patients.Methods: The patients of subacute stroke (within four weeks) in our institution between 2015 and 2016 were recruited. Patients’ characteristics and QOL were obtained from medical charts and stroke-specific quality of life scale (SS-QOL). Associations of each domain in SS-QOL with socio-demographic, clinical factors and patient satisfaction were investigated using the linear regression models.Results: Among the 203 subjects, 60 were diagnosed as large artery atherosclerosis (LAA), 80 were small-artery occlusion (SAO), 28 were cardioembolism (CE) and 35 were intracranial haemorrhage (ICH). The ICH group had the worst self-care ability and upper extremity function. Worse severity of stroke was associated with lower levels of language ability, mobility, mood status and upper-extremity function. Participants who had better satisfaction had high levels of capability of conducting family roles, positive emotions, personality consistency, self-care ability and capacity of conducting social roles.Conclusions: The level of patient satisfaction, duration of hospitalisation and the severity of stroke were found to be the three important factors associated with SS-QOL at hospital discharge, indicating doctors might assist patients adjust to the consequences of stroke and improve the QOL of subacute stroke.

French validation of the Stroke Specific Quality of Life Scale (SS-QoL).

To adapt the SS-QoL into French and test its psychometric properties. Seventy-seven patients from a population-based registry were enrolled 3 months after their stroke. SS-QoL, NIHSS score, Barthel index, HAD, FSS, SF-36 scales, and MMSE were administered at enrolment. SS-QoL was re-administered at 15 days and 2 months. Internal consistency was assessed by Cronbach's α coefficients, factorial validity by an exploratory factor analysis and external validity by Mann-Whitney test and Spearman's correlations (ρ), comparing SS-QoL scores with those obtained from established scales. Reliability was assessed by intra-class correlation coefficients (ICC) and responsiveness by standardized effect sizes (ES). Test-retest and inter-observer reliabilities were excellent (ICC> 0.88). Internal consistency was acceptable (α= 0.65-0.91), except for the Personality domain (α= 0.58). Factor analysis individualized eight homogenous axes. SS-QoL scores were different between groups opposed by their modified Rankin score at enrolment or their overall quality of life compared with pre-stroke status (p < 0.001). Ten of the twelve domains correlated moderately (ρ> 0.35) to strongly (ρ> 0.5) with established measures. Nine domains were mildly to moderately responsive to change (ES> 0.3). The French version of the SS-QoL is a valid, reliable and moderately responsive instrument.

Validity, reliability and Norwegian adaptation of the Stroke-Specific Quality of Life (SS-QOL) scale.

Background:There is a paucity of stroke-specific instruments to assess health-related quality of life in the Norwegian language. The objective was to examine the validity and reliability of a Norwegian version of the 12-domain Stroke-Specific Quality of Life scale.Methods:A total of 125 stroke survivors were prospectively recruited. Questionnaires were administered at 3 months; 36 test–retests were performed at 12 months post stroke. The translation was conducted according to guidelines. The internal consistency was assessed with Cronbach’s alpha; convergent validity, with item-to-subscale correlations; and test–retest, with Spearman’s correlations. Scaling validity was explored by calculating both floor and ceiling effects. A priori hypotheses regarding the associations between the Stroke-Specific Quality of Life domain scores and scores of established measures were tested. Standard error of measurement was assessed.Results:The Norwegian version revealed no major changes in back translations. The internal consistency values of the domains were Cronbach’s alpha = 0.79–0.93. Rates of missing items were small, and the item-to-subscale correlation coefficients supported convergent validity (0.48–0.87). The observed floor effects were generally small, whereas the ceiling effects had moderate or high values (16%–63%). Test–retest reliability indicated stability in most domains, with Spearman’s rho = 0.67–0.94 (all p < 0.001), whereas the rho was 0.35 (p < 0.05) for the ‘Vision’ domain. Hypothesis testing supported the construct validity of the scale. Standard error of measurement values for each domain were generated to indicate the required magnitudes of detectable change.Conclusions:The Norwegian version of the Stroke-Specific Quality of Life scale is a reliable and valid instrument with good psychometric properties. It is suited for use in health research as well as in individual assessments of persons with stroke.

The influences of client-centered therapy on the level of performance, the level of satisfaction of activity of daily living, and the quality of life of the chronic stroke patients.

[Purpose] The purpose of this research is to take a look at the influences of client-centered therapy on the level of everyday life performance, the level of satisfaction, and the quality of life of the chronic stroke patients. [Subjects and Methods] This research used client-centered therapy with two chronic stroke and hemiplegia patients as subjects. The therapy was carried out once a day, five times a week, for thirty minutes at a time for four weeks. Also, five kinds of training were included in the medical treatment programs which were organized after the initial Canadian occupational performance measure (COPM) evaluations. Evaluations were carried out before and after the mediation. Changes in the level of everyday life performance level of satisfaction were measured using the COPM, and changes in quality of life were measured using the Stroke Specific Quality of Life Scale (SS-QOL). [Results] After the application of medical treatment, both subjects showed positive changes in terms of the level of everyday life performance, level of satisfaction, and quality of life. [Conclusion] Both subjects demonstrated improvements in all aspects of both outcome measurements which implied that a short client-centered therapy program could help chronic stroke patients improve some aspects of their life.

Quality of life after stroke: impact of clinical and sociodemographic factors

OBJECTIVES:The aim of the study was to analyze the impact of ischemic stroke on health-related quality of life (QoL) and associate this event with individuals' clinical and sociodemographic characteristics.METHODS:We investigated the clinical and demographic aspects of stroke patients. The Modified Rankin Scale, National Institutes of Health Stroke Scale (NIHSS) and the Stroke Specific Quality of Life Scale (SS-QoL) were used for correlation analysis.RESULTS:Among 131 patients with ischemic stroke, 53.4% of patients presented with moderate to severe disability on the Rankin Scale. According to the SS-QoL, several QoL domains were compromised. QoL was significantly negatively correlated with the values of the Rankin and NIHSS scales, indicating lower QoL among people with worse functional status and greater clinical severity of stroke (p<0.001). The use of orthosis and total anterior circulation infarct subtype of stroke led to a more marked reduction in QoL.CONCLUSION:The present study described an inversely proportional relationship between the severity of stroke, disability and QoL. The use of orthosis also had a negative impact on QoL. Early identification of these factors could promote better interventions for individuals with ischemic stroke, minimizing disabilities and improving QoL.

Comparison of construct validity of two short forms of Stroke-Specific Quality of Life scale

BackgroundNo studies have compared the 2-factor structures of Wong’s and Post’s versions of the short-form Stroke-Specific Quality of Life (i.e., 12-item SSQOL) scale. This study compared the construct validity of 2 short-forms of the 12-item-SSQOL (not the 12-domain-SSQOL).MethodsData were obtained from a previous validation study of the original 49-item SSQOL in 263 patients. Construct validity was tested by confirmatory factor analysis (CFA) to examine whether the two-factor structure, including psychosocial and physical domains, was supported in both versions. The CFA tested the data-model fit by indices: chi-square χ2/df ratio, root mean square error of approximation (RMSEA), comparative fit index (CFI), nonnormative fit index (NNFI), standard root mean square residual (SRMR), and parsimony normed fit index (PNFI). Item factor loadings (cutoffs: .50) were examined. Model fit was compared using Akaike information criterion (AIC) and consistent AIC (i.e., CAIC) values.ResultsAll model fit indices for Post’s version fell within expected ranges: χ2/df ratio = 2.02, RMSEA = 0.05, CFI = 0.97, NNFI = 0.97, SRMR = 0.06, and PNFI = 0.76. In the psychosocial domain, the item factor loadings ranged from 0.46 to 0.63. In the physical domain, all items (except the language and vision items) had acceptable factor loadings (0.68 to 0.88). However, in Wong’s version, none of the model indices met the criteria for good fit. In model fit comparisons, Post’s version had smaller AIC and CAIC values than did Wong’s version.ConclusionsAll fit indices supported Post’s version, but not Wong’s version. The construct validity of Post’s version with a 2-factor structure was confirmed, and this version of the 12-item SSQOL is recommended.

The positive effects of Xueshuan Xinmai tablets on brain functional connectivity in acute ischemic stroke: a placebo controlled randomized trial

Through a placebo controlled randomized study, the purpose of this report was to investigate the effects of Xueshuan Xinmai tablets (XXMT) on neurologic deficits, quality of life and brain functional connectivity in acute ischemic stroke patients and to explore the mechanism of action of XXMT. In total, 44 acute ischemic stroke patients were randomly divided to the XXMT treatment group (n = 22) or the placebo group (n = 22) in a 2-week trial. Before and after the treatment, the neurological assessment and functional magnetic resonance imaging examinations were carried out. Compared to the placebo group, the scores of the National Institutes of Health Stroke Scale (NIHSS) and Stroke-Specific Quality of Life Scale (SSQOL) significantly improved in the treatment group. In addition, XXMT-treated patients demonstrated significantly enhanced functional connectivity within the default mode, frontal-parietal, and motor control networks. Furthermore, the changed connectivity in the left precuneus was positively correlated to the improvement of NIHSS and SSQOL scores. The present study indicated that XXMT treatment significantly improved the neurologic deficit and quality of life of acute ischemic stroke patients and that the therapeutic effect may be based on the modulation of XXMT on the functional connectivity of brain networks.

Validity and reliability of a Nigerian-Yoruba version of the stroke-specific quality of life scale 2.0

BackgroundPsychometric evidence is necessary to establish scientific integrity and clinical usefulness of translations and cultural adaptations of the Stroke-Specific Quality of Life (SS-QoL) scale. However, the limited evidence on psychometrics of Yoruba version of SS-QoL 2.0 (SS-QoL(Y)) is a significant shortcoming. This study assessed the test-retest reliability, internal consistency, convergent, divergent, discriminant and known-group validity of the SS-QoL(Y).MethodsYoruba version of the WHOQoL-BREF was used to test the convergent and divergent validity of the SS-QoL(Y) among 100 consenting stroke survivors. The WHOQoL-BREF and SS-QoL(Y) was administered randomly in order to eliminate bias. The test-retest reliability of the SS-QoL(Y) was carried out among 68 of the respondents within an interval of 7 days. All respondents were purposively recruited from selected secondary and tertiary health facilities in South-west Nigeria. Data were analysed using descriptive statistics of mean and standard deviation, and inferential statistics of Spearman correlation, Cronbach’s alpha, Intra-class Correlation Coefficient (ICC), Independent t-test and One-way ANOVA. Alpha level was set at p < 0.05.ResultThe physical health, psychological health, social relationship and environment domains on WHOQoL-BREF with correlation coefficient that ranged from 0.214 to 0.360 showed significant correlation with similar domains on SS-QoL(Y). Dissimilar domains between the two scales had r values from 0.035 to 0.366. Discriminant validity of SS-QoL(Y) showed that items’ r value ranged from 0.711 to 0.920 with their hypothesized domains. The scale demonstrated moderate to strong test-retest reliability with Intra-class correlation coefficient (ICC) for the domains and overall scores (r = 0.47 to 0.81) and moderate to high internal consistency (Cronbach’s alpha =0.61 to 0.82) for domains scores. These correlations were also significant for the domains and overall scores (p < 0.05). There were no significant differences across different age groups or gender for the domains or overall scores of SS-QoL(Y).ConclusionsDiscriminant and known-group validity, test-retest reliability and internal consistency of the Yoruba version of the Stroke Specific Quality of Life 2.0 are adequate while the convergent and divergent validity are low but acceptable. The SS-QoL(Y) is recommended for assessing health-related quality of life among Yoruba stroke survivors.

Efeito da hidroterapia no condicionamento cardiovascular e na qualidade de vida de pacientes após acidente vascular encefálico

Introduo: os efeitos do treinamento cardiovascular so potencializados quando realizados na piscina teraputica devido s propriedades fsicas da gua. Objetivo: avaliar os efeitos de um protocolo de hidroterapia na qualidade de vida e no condicionamento cardiovascular de pacientes ps-AVE. Mtodos: dez pacientes foram divididos nos grupos: controle (exposto ao protocolo de exerccios no solo) e experimental (submetidos a 10 sesses de hidroterapia). As medidas para frequncia cardaca e respiratria, o nmero de voltas, saturao de oxignio durante o teste de caminhada de seis minutos e qualidade de vida segundo a escala EQVE-AVE, foram avaliadas antes e aps o programa de atividades. Resultados: houve um aumento expressivo da quantidade de voltas [12,80 2,78 (p=0,01) ] em ambos os grupos e dos escores para a qualidade de vida [196,2042,92 (p=0,046) ] apenas no grupo experimental em relao a condio inicial. Concluso: o protocolo de hidroterapia promoveu os mesmos efeitos do treinamento no solo sobre o condicionamento cardiovascular, no entanto, foi capaz de promover um aumento dos escores para qualidade de vida.

Stroke survivors' levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area.

BackgroundStroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver.AimTo determine stroke survivors’ levels of community reintegration, quality of life (QOL), satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area.MethodThis was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire.ResultsA total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73) and 58% (n = 62) had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55%) caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p < 0.0001) and QOL (r = 0.51, p < 0.0001). A negative correlation was found between community reintegration and caregiver strain (r = -0.37, p < 0.0001).ConclusionMost stroke survivors are reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services.