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Category: Volume 07 Issue 08 August 2019
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Title: Quality of life in post stroke patients with early rehabilitation intervention: A cross sectional study

Authors: Dr PC Muralidharan, Dr Vipin Kumar K, Dr G Chitra, Dr K Sreejith, Dr S Abdul Gafoor

 DOI: https://dx.doi.org/10.18535/jmscr/v7i8.10

Abstract

Background:  Rehabilitation enhances neurological recovery in stroke and improves the functional status. It is vital in the treatment of stroke. The quality of life depends on various physical, mental and psycho social factors and functional independence. Quality of life in a stroke survivor is a measure of success of rehabilitation. There are very few studies associating initiation of rehabilitation and quality of life in post stroke patients.

Objectives: The study aims to assess the difference in quality of life in stroke subjects who received early rehabilitation and in those who did not. This study also evaluates the association of demographic and physical variables with early rehabilitation in a stroke survivor. 

Materials and Methods: A cross sectional study conducted in the outpatient clinic of Department of Physical Medicine and Rehabilitation, Government Medical College Kottayam among the post stroke patients 3-6 months after the first episode of stroke. Data was collected from the patients through questionnaire to assess the socio-demographic variables and stroke specific quality of life (SSQOL).

Results: Of the 200 subjects recruited for the study, 141 received early rehabilitation and their mean total SSQOL score was182.82 while the mean score for the  group which did not receive early rehabilitation was 159.29, which was statistically significant (p<0.05).  The mean age in the group who received early rehabilitation was less than the other, which was statistically significant. The other demographic variables did not show significant association with early rehabilitation. Pain and independence in gait showed significant association with early rehabilitation.

Conclusion: Subjects who received early rehabilitation after stroke had better quality of life than those who did not. Moreover those who had early rehabilitation were more independent in gait and had better perception of pain compared to others.  The study calls for the initiation of rehabilitation early in the stroke treatment pathway.

Keywords: Stroke, Early rehabilitation, Quality of life.   

References

  1. King R.B. Quality of life after stroke. Stroke.1996 Sep;27(9):1467-72
  2. Stroke Statistics|Internet Stroke Center [Internet]. cited 2018 Jun20, 10 AM] Available from:http://www.strokecenter.org/patients/about-stroke-statistics.
  3. Vasantha M Padma, Rohit Bhatia.et al. call for neurologists to take up stroke interventions. Ann Indian Acad Neurol.2016 Oct- Dec;19(4):429-4328
  4. Feigin VL et.al. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: A systemic review. Lancet Neurol.2009;8:355-69
  5. Fergin, Bo Norrving, George A Mensa. Global burden of stroke. Circulation Research, February 3, 2017;439
  6. Eitan Auriel,Natan M Bornstein. Early Mobilisation Following stroke. European Neurological review 2013;8(2):141-3
  7. Hebert D et.al. Canadian stroke best practice recommendations: Stroke rehabilitation practice   guidelines, update 2015. International Journal of Stroke. Vol.11(4)459-484
  8. Mohammed Alim.et.al. Family-led rehabilitation after stroke in India: the ATTEND trial, study protocol for a randomized controlled trial.Trials.2016; 17:13
  9. Siew Kwaon Luiand Minh Ha Nguyen. Elderly Stroke Rehabilitation: Overcoming the Complications and Its Associated Challenges. Curr Gerontol Geriatr Res. 2018; 2018: 9853837.
  10. Elisheva R. Coleman.et.al. Early Rehabilitation After Stroke: a Narrative Review. Curr Atheroscler Rep. 2017 Nov 7; 19(12): 59.
  11. Cathy Stinear, Suzanne Ackerley and Winston Byblow. Rehabilitation is Initiated Early After Stroke, but Most Motor Rehabilitation Trials Are Not. A Systematic Review. 2013; 44: 2039–2045
  12. Sundseth A, Thommessen B, Ronning OM. Outcome after mobilization within 24 hours of acute stroke: a randomized controlled trial. Stroke. 2012; 43: 2389–2394. 
  13. Hayes SH, Carroll SR: Early intervention care in acute stroke patient. Arch Phys Med Rehabil67:319- 321
  14. WHO QOL group, Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998: 28: 551-558.
  15. Moon, Kim.et.al. Correlates of quality of life after stroke. Journal of the Neurological Sciences.2004; 224:37-41
  16. Kamel A, Ghani AA, Zaiton MA, El-Motayam AS, El-Fattah DA. Health related quality of life in stroke survivors measured by the Stroke Impact Scale. Egypt J Neurol Psychiatry Neurosurg. 2010; 47:267–74.
  17. JA Opara and K Jaracz. Quality of life of post-stroke patients and their caregivers. J Med Life.2010 Aug15;3(3):216-220 [Published online2010 Aug 25]
  18. William G Akanksha et al. Clinical Features, Risk Factors, and Short- term outcome of Ischemic Stroke in Patients with Atrial Fibrillation: Data from a Population- based Study. Ann Indian Acad Neurol.2017 July-Sep;20(3):289-293
  19. Edja Solange Souza Rangel; Angélica Gonçalves Silva Belasco; Solange Diccini. Quality of life of patients with stroke rehabilitation. Available from: http://www.scielo.br/scielo.php?pid=S0103-21002013000200 016& script=sci_arttext&tlng=en
  20. Dr PC Muralidharan et.al. Quality of Life in Stroke Survivors in Central Kerala. JMSCR Volume 07 Issue 06 June 2019 986-995
  21. Pan, Xiao-Li, MD. Efficacy of early rehabilitation therapy on movement ability of hemiplegic lower extremity in patients with acute cerebrovascular accident. Medicine: January 2018 - Volume 97 - Issue 2 - p e9544
  22. MJ Reeves, et.al. Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes. Lancet Neurol.2008 Oct;7(10):915-926
  23. Aprile et.al. Pain in stroke patients: characteristics and impact on the rehabilitation treatment. A multicentral cross-sectional study. Eur J Phys Rehabil Med 2015 Feb 26 51(6),725-36

Corresponding Author

Dr PC Muralidharan

Asst Professor, Dept of Physical Medicine and Rehabilitation. Govt Medical College, Kottayam