Factors Influencing Stroke Survivors’ Quality of Life During Subacute Recovery

School of Allied Medical Professions, The Ohio State University, Columbus, Ohio 43210, USA.
Stroke (Impact Factor: 5.72). 08/2005; 36(7):1480-4. DOI: 10.1161/01.STR.0000170706.13595.4f
Source: PubMed


Health-related quality of life (HRQOL) is an important index of outcome after stroke and may facilitate a broader description of stroke recovery. This study examined the relationship of individual and clinical characteristics to HRQOL in stroke survivors with mild to moderate stroke during subacute recovery.
Two hundred twenty-nine participants 3 to 9 months poststroke were enrolled in a national multisite clinical trial (Extremity Constraint-Induced Therapy Evaluation). HRQOL was assessed using the Stroke Impact Scale (SIS), Version 3.0. The Wolf Motor Function Test documented functional recovery of the hemiplegic upper extremity. Multiple analysis of variance and regression models examined the influence of demographic and clinical variables across SIS domains.
Age, gender, education level, stroke type, concordance (paretic arm=dominant hand), upper extremity motor function (Wolf Motor Function Test), and comorbidities were associated across SIS domains. Poorer HRQOL in the physical domain was associated with age, nonwhite race, more comorbidities, and reduced upper-extremity function. Stroke survivors with more comorbidities reported poorer HRQOL in the area of memory and thinking, and those with an ischemic stroke and concordance reported poorer communication.
Although results may not generalize to lower functioning stroke survivors, individual characteristics of persons with mild to moderate stroke may be important to consider in developing comprehensive, targeted interventions designed to maximize recovery and improve HRQOL.

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    • "Patients with a neurological disorder such as stroke or cerebral palsy, often suffer from hemiparesis, spasticity and coordination disorders, leading to loss of arm-hand function and consequently loss of arm-hand performance [1] [2] [3] [4] [5]. This limits the execution of ADL, affecting their daily life extremely, and resulting in greater dependency, restricted social participation [6] and decreased quality of life [7]. "
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    ABSTRACT: Neurological patients often encounter arm-hand problems in daily life. Body worn sensors may be used to assess actual performance by quantifying specific movement patterns associated with specific activities. However, signal reliability during activities of daily living should be determined first. Aim is to determine to what extent standardized arm-hand skill performance of both healthy adults and healthy children can be recorded reliably using a combination of multiple sensor devices. Thirty adults (aged>50 years) and thirty-two children (aged between 6-18 years) performed the activities drinking, eating and combing 5 times in a standardized setting. Sensor devices, each containing a triaxial accelerometer, gyroscope and magnetometer were attached to the arms, hands and trunk of the participants. Within-subject and between-subject reliability of the signal patterns amongst skill repetitions was determined by calculating Intraclass-Correlation-Coefficients (ICCs). Median reliability was good to very good for all activities performed (both within and between subjects). Regarding within-subject reliability (instruction-condition), median ICCs ranged between 0.76-0.90 and 0.68-0.92 for the adults and children respectively. For between-subject reliability (instruction-condition), median ICCs ranged 0.75-0.86 and 0.61-0.90 for the adults and children respectively. It can be concluded that the abovementioned sensor system can reliably record activities of daily living in a standardized setting.
    IEEE Transactions on Neural Systems and Rehabilitation Engineering 02/2015; 23(4). DOI:10.1109/TNSRE.2015.2396082 · 3.19 Impact Factor
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    • "Among these survivors, a large proportion (46% to 95%) remains symptomatic six months after the ischemic stroke event [2]. Loss of arm function adversely affects quality of life [3], and functional motor recovery in affected upper extremities in patients with hemiplegia is the primary goal of physical therapists [4]. Continuous rehabilitation training following subcortical damage in movement disorders can achieve motor function recovery [5]. "
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    ABSTRACT: Objectives. To evaluate whether combining mental practice with physical practice training enhances hand function in patients with stroke. Methods. 10 for treatment and 10 for control were recruited for this pre/posttraining matched case control study. In the treatment group, subjects underwent combining mental practice with physical practice for four weeks. In the control group, subjects only participated in physical practice. Change of hand function and the number of activated voxels of the contralateral somatosensory motor cortex (SMC) acquired by functional magnetic resonance imaging were measured. Results. After training, the Action Research Arm Test score increased by 12.65 for treatment and by 5.20 for control. There was a significant difference in the Action Research Arm Test score between the two groups (P = 0.04). The activated voxels number of the contralateral SMC increased in both groups, but the activated voxels number in the contralateral SMC and the improvement of hand function for treatment were greater than for control. In the treatment group, the number of activated voxels of the contralateral SMC was positively correlated with better hand function scores. Conclusions. Combining mental practice with physical practice may be a more effective treatment strategy than physical training alone for hand recovery in stroke patients.
    Behavioural neurology 11/2014; 2014:876416. DOI:10.1155/2014/876416 · 1.45 Impact Factor
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    • "İnme sonrası motor fonksiyonlarda iyileşme, inmenin başlangıcında hasta üzerinde bıraktığı motor defisitenin yoğunluğuna bağlı olmakla beraber en yüksek oranda ilk üç ay içinde gerçekleşmekte olup 6 ay içinde iyileşme oranı yavaşlayarak hastanın durumu kronikleşmektedir [5]. Üst ekstremite fonksiyonları, bireylerin günlük yaşam aktiviteleri üzerinde alt ekstremiteye göre çok daha dominant etkiye sahip olduğu görülmektedir [6]. Üst ekstremite fonksiyonlarındaki yetersizlik, inme sonrası ilk 3. (üçüncü) ay ile 6. (altıncı) ay arasında hastaların birçoğunda (%55 ila %75 oranında) süreklilik göstermektedir [7]. "
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    ABSTRACT: Abstract: Science and technological developments have not been enough used to enhance rehabilitation engineering as desired.This study suggests to develop a system that provides objective, reliable, sensitive and quantitatively measurable parameters that can be used in placed of subjective clinical upper extremity motor function assessment methods.
    Tıp Teknolojileri Ulusal Kongresi TIPTEKNO14; 09/2014
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