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Çapraz K, Aydoğan Arslan S, Çolak T. Investigation of the reliability and validity of the Turkish version of the Sitting Balance Scale in individuals with stroke. Acta Neurol Belg 2024; 124:81-89. [PMID: 37517006 DOI: 10.1007/s13760-023-02343-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE The purpose of the study was to investigate the reliability and validity of the Turkish version of the Sitting Balance Scale (SBS-T). METHODS SBS-T was tested with 60 individuals with stroke. Test-retest reliability was calculated with the Intraclass Correlation Coefficient (ICC). The Trunk Impairment Scale (TIS), Function in Sitting Test (FIST), The Berg Balance Scale (BBS), and Barthel Index (BI) were used to test the validity of SBS-T. The internal consistency of the SBS-T items was calculated with the Cronbach Alpha Analysis. Factor analysis and hypothesis testing were used for construct validity. Ceiling and floor effects were calculated for reliability. RESULTS The intra-observer ICC was found to be 0.970 and the inter-observer ICC value was 0.999. The Cronbach's Alpha Coefficient was detected to be 0.955. A high correlation was detected between SBS-T and TIS, BBS, FIST, and BI (r = 0.861, p = 0.001; r = 0.849, p = 0.001; r = 0.906, p = 0.001; r = 0.848, p = 0.001, respectively). CONCLUSION As a result of the factor analysis, it was found that the scale was determined by one single factor. No ceiling and floor effects were detected. The Turkish version of the SBS is a valid and reliable scale for predicting mobility and functionality in stroke for use in clinical and scientific studies. CLINICALTRIALS GOV IDENTIFIER NCT04801927.
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Affiliation(s)
- Kübra Çapraz
- Kastamonu Physical Therapy and Rehabilitation Center, Kastamonu, Turkey
| | - Saniye Aydoğan Arslan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kırıkkale University, Kırıkkale, Turkey.
| | - Teoman Çolak
- Department of Neurology, Kastamonu Olukbaşı Anadolu Hospital, Kastamonu, Turkey
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Franc IA, Mauldin S, Roberts M, Rosa-DiStefano G. Inter-Rater and Intra-Rater Reliability of the Kansas University Sitting Balance Scale. Occup Ther Health Care 2023; 37:595-605. [PMID: 35635275 DOI: 10.1080/07380577.2022.2082000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/17/2022] [Accepted: 05/22/2022] [Indexed: 06/15/2023]
Abstract
Kluding et al., created The Kansas University Sitting and Standing Balance Scales (KUSSBS) in 2006 to meet the need for objective documentation of balance and for a tool without a floor effect. Rater reliabilities were established by Kluding for the standing scale, but not for the sitting balance scale (KUSitBS). The aim of this study was to establish inter- and intra-rater reliability for the KUSitBS. Four occupational therapists were recruited to rate a videotaped performance of a simulated patient. Resulting inter-rater reliability inter-class coefficients (ICC) are good, ICC = .877, p < .01, suggesting that sitting balance on the KUSitBS was rated similarly across coders. Intra-rater reliability ICC are excellent, ICC = .914, indicating that each occupational therapist rated sitting balance on the KUSitBS similarly at initial assessment and then again two weeks later. In order to have confidence in using any assessment tool, intra- and inter-rater reliability must be established. This study's results advance the use of the KUSitBS with adult populations.
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Affiliation(s)
- Ingrid A Franc
- Department of Occupational Therapy, Louisiana State University Health Sciences - New Orleans
| | - Samantha Mauldin
- Department of Occupational Therapy, Louisiana State University Health Sciences - New Orleans
| | - Magdalena Roberts
- Department of Occupational Therapy, Louisiana State University Health Sciences - New Orleans
| | - Gregoria Rosa-DiStefano
- Department of Occupational Therapy, Louisiana State University Health Sciences - New Orleans
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Inoue M, Amimoto K, Shida K, Sekine D, Hasegawa D, Fukata K, Fujino Y, Makita S, Takahashi H. Effects of Dynamic Sitting Exercise with Delayed Visual Feedback in the Early Post-Stroke Phase: A Pilot Double-Blinded Randomized Controlled Trial. Brain Sci 2022; 12:brainsci12050670. [PMID: 35625055 PMCID: PMC9139189 DOI: 10.3390/brainsci12050670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/09/2022] [Accepted: 05/18/2022] [Indexed: 11/16/2022] Open
Abstract
Sitting ability in the early post-stroke phase affects functional balance ability and other prognoses. We investigated whether dynamic sitting exercise with delayed visual feedback in the mediolateral and anteroposterior directions affected postural control in the early post-stroke phase. In this pilot randomized controlled trial, 27 hemiparetic stroke patients were randomized to experimental (n = 13) and control (n = 14) groups. Dynamic sitting exercise (30 times/day, 5 days/week) in the mediolateral and anteroposterior directions, with 500-ms-delayed (experimental group) or real-time (control group) visual feedback on a computer, was added to usual physical therapy. We evaluated the postural assessment scale for stroke (PASS), static and dynamic sitting balance tasks, the five-times sit-to-stand test, trunk impairment scale, functional ambulation category, and functional independence measure−motor items. In intention-to-treat analysis, the experimental group demonstrated a significant intervention effect on the PASS score (p < 0.05). The mean percentage of body weight on the moving side in the lateral sitting task and the number of successes in the five-times sit-to-stand test were significantly higher in the experimental group than those in the control group (p < 0.05). Thus, the proposed exercise improves postural control, dynamic sitting balance, and sit-to-stand ability in early post-stroke patients.
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Affiliation(s)
- Masahide Inoue
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
- Department of Physical Therapy, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo 116-8551, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo 116-8551, Japan
- Correspondence: ; Tel.: +81-3-3819-1211
| | - Kohei Shida
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
- Department of Physical Therapy, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo 116-8551, Japan
| | - Daisuke Sekine
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
| | - Daichi Hasegawa
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
| | - Kazuhiro Fukata
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
| | - Yuji Fujino
- Department of Physical Therapy, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan;
| | - Shigeru Makita
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
| | - Hidetoshi Takahashi
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
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Prognostic factors of functional outcome in post-acute stroke in the rehabilitation unit. J Formos Med Assoc 2021; 121:670-678. [PMID: 34303583 DOI: 10.1016/j.jfma.2021.07.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND/PURPOSE This retrospective study aimed to determine which factors, such as cognition, motor recovery, swallowing function, and bladder and bowel functions, significantly predicted independence in the activities of daily living (ADL) at hospital discharge in a domestic population of patients experiencing post-acute stroke who received in-hospital rehabilitation. METHODS We reviewed medical records that were retrieved from the Integrated Medical Database, National Taiwan University Hospital (NTUH-iMD) of 3000 patients who suffered from stroke and were admitted to NTUH from 2014 to 2017. The main outcome measure was independence in the basic ADL (modified Barthel index [mBI]) at discharge. Regression analyses were used to identify prognostic factors for the basic ADL (mBI). RESULTS The total mBI improved from 40.7 ± 33.0 to 63.1 ± 34.1 in eligible 2538 patients during their hospital stay. The baseline daily activity function (R2 change = 0.042) was the most important prognostic factor associated with independence at discharge, followed by dependence in sitting up (R2 change = 0.014), impaired sitting balance (R2 change = 0.010), the Brunnstrom stage of hemiplegic lower limb (R2 change = 0.006), and the presence of bladder incontinence (R2 change = 0.006) assessed by physician upon rehabilitation admission (R2 = 0.53, p < 0.05). Dependency in sitting up, impaired sitting balance, and the presence of urinary incontinence were negative prognostic factors of ADL independence at discharge (p < 0.05). By contrast, the Brunnstrom stage of hemiplegic lower limb and baseline mBI scores at rehabilitation admission were positive prognostic factors of ADL independence at discharge (p < 0.05). CONCLUSION Baseline ADL function was the most important prognostic factor of functional independence in post-acute stroke. Moreover, the activity limitation of dependency on sitting up and motor function impairment of hemiplegic lower limb prognosticated functional independence.
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Postural Assessment Scale for Stroke Patients in Acute, Subacute and Chronic Stage: A Construct Validity Study. Diagnostics (Basel) 2021; 11:diagnostics11020365. [PMID: 33670068 PMCID: PMC7927023 DOI: 10.3390/diagnostics11020365] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 11/24/2022] Open
Abstract
(1) Background: Observational scales are the most common methodology used to assess postural control and balance in people with stroke. The aim of this paper was to analyse the construct validity of the Postural Assessment Scale for Stroke Patients (PASS) scale in post-stroke patients in the acute, subacute, and chronic stroke phases. (2) Methods: Sixty-one post-stroke participants were enrolled. To analyze the construct validity of the PASS, the following scales were used: the Functional Ambulatory Category (FAC), the Wisconsin Gait Scale (WGS), the Barthel Index (BI) and the Functional Independence Measure (FIM). (3) Results: The construct validity of the PASS scale in patients with stroke at acute phase was moderate with the FAC (r = −0.791), WGS (r = −0.646) and FIM (r = −0.678) and excellent with the BI (r = 0.801). At subacute stage, the construct validity of the PASS scale was excellent with the FAC (r = 0.897), WGS (r = −0.847), FIM (r = −0.810) and BI (r = −0.888). At 6 and 12 months, the construct validity of the PASS with the FAC, WGS, FIM and BI was also excellent. (4) Conclusions: The PASS scale is a valid instrument to assess balance in post-stroke individuals especially, in the subacute and chronic phases (at 6 and 12 months).
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Relationships between motor and cognitive functions and subsequent post-stroke mood disorders revealed by machine learning analysis. Sci Rep 2020; 10:19571. [PMID: 33177575 PMCID: PMC7658360 DOI: 10.1038/s41598-020-76429-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 10/28/2020] [Indexed: 11/08/2022] Open
Abstract
Mood disorders (e.g. depression, apathy, and anxiety) are often observed in stroke patients, exhibiting a negative impact on functional recovery associated with various physical disorders and cognitive dysfunction. Consequently, post-stroke symptoms are complex and difficult to understand. In this study, we aimed to clarify the cross-sectional relationship between mood disorders and motor/cognitive functions in stroke patients. An artificial neural network architecture was devised to predict three types of mood disorders from 36 evaluation indices obtained from functional, physical, and cognitive tests on 274 patients. The relationship between mood disorders and motor/cognitive functions were comprehensively analysed by performing input dimensionality reduction for the neural network. The receiver operating characteristic curve from the prediction exhibited a moderate to high area under the curve above 0.85. Moreover, the input dimensionality reduction retrieved the evaluation indices that are more strongly related to mood disorders. The analysis results suggest a stress threshold hypothesis, in which stroke-induced lesions promote stress vulnerability and may trigger mood disorders.
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Fukata K, Fujino Y, Inoue M, Inoue M, Sekine D, Tsutsumi M, Okihara T, Mano M, Miki H, Sato H, Kobayashi Y, Hasegawa K, Kunieda Y, Ishihara S, Makita S, Takahashi H, Amimoto K. Factors Influencing Sitting Ability During the Acute Post-Stroke Phase: A Multicenter Prospective Cohort Study in Japan. J Stroke Cerebrovasc Dis 2020; 30:105449. [PMID: 33166768 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/23/2020] [Accepted: 10/31/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES Sitting ability during the acute phase after stroke is a useful indicator of functional outcomes; however, factors that affect this ability have not been evaluated. Therefore, this study aimed to identify and evaluate factors that affect sitting ability in the acute phase after stroke. MATERIALS AND METHODS This multicenter prospective cohort study included hemispheric stroke patients who underwent an inpatient rehabilitation program after acute stroke from five acute care hospitals. The effect of age, sex, lesion side, etiology, consciousness disorder, stroke and dementia history, stroke-related complications, National Institutes of Health Stroke Scale score, hemiparalysis, turn-over movement from the supine position and sit-up movement, and Scale for Contraversive Pushing on the "remain sitting" item in the revised version of the Ability of Basic Movement Scale at the time of acute hospital discharge were investigated. Factors affecting sitting ability were identified using binomial logistic regression analysis. RESULTS We included 293 stroke patients. Age (odds ratio: 0.943, 95% confidence interval: 0.910-0.977, p=0.001), National Institutes of Health Stroke Scale score (odds ratio: 0.862, 95% confidence interval: 0.811-0.916, p<0.001), and Scale for Contraversive Pushing score (odds ratio: 0.543, 95% confidence interval: 0.419-0.705, p<0.001) were identified as independent predictors of sitting ability at the time of hospital discharge (median; 23.0 days). CONCLUSIONS Older patients and those with high Scale for Contraversive Pushing and National Institutes of Health Stroke Scale scores experienced difficulties in regaining sitting ability. These results may guide physical therapy for patients with impaired sitting ability due to hemispheric stroke.
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Affiliation(s)
- Kazuhiro Fukata
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Saitama, Japan.
| | - Yuji Fujino
- Department of Physical Therapy, Faculty of Health Sciences, Juntendo University, Tokyo, Japan
| | - Masahide Inoue
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Saitama, Japan; Department of Physical Therapy, Faculty of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Mamiko Inoue
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Daisuke Sekine
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Saitama, Japan; Department of Physical Therapy, Faculty of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Misato Tsutsumi
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tetsuya Okihara
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masayuki Mano
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hiroshi Miki
- Department of Rehabilitation, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Hirofumi Sato
- Department of Rehabilitation, Saitama Citizens Medical Center, Saitama, Japan
| | - Yohei Kobayashi
- Department of Rehabilitation, Saitama Sekishinkai Hospital, Saitama, Japan
| | - Koki Hasegawa
- Department of Rehabilitation, Sainokuni Higashiomiya Medical Center, Saitama, Japan
| | - Yota Kunieda
- Department of Rehabilitation, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Shunichi Ishihara
- Department of Psychology, Faculty of Human Sciences, Bunkyo University, Saitama, Japan
| | - Shigeru Makita
- Department of Rehabilitation, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hidetoshi Takahashi
- Department of Rehabilitation, Saitama Medical University International Medical Center, Saitama, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Faculty of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
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Kim DS, Ko MH, Won YH, Park SH, Seo JH, Kim GW. The Relations between Sitting Balance and Functional Recovery according to Characteristics of the Stroke Patients. BRAIN & NEUROREHABILITATION 2019; 13:e2. [PMID: 36744268 PMCID: PMC9879528 DOI: 10.12786/bn.2020.13.e2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 11/08/2022] Open
Abstract
We measured the difference of sitting pressure between the affected and unaffected sides (DSPAU) using sitting pressure measured with a force platform to identify sitting imbalance. The aim of this study is to investigate the relations between sitting balance and functional status or parameters according to characteristics stroke patients. We examine changes in DSPAU and functional assessment before and after a 3 week of rehabilitation in hemiplegic stroke patients (n = 73). These pre- and post-treatment data according to stroke characteristics, and correlations between the DSPAU and functional scales were analyzed. The DSPAU was greater in the non-ambulatory group compared to the ambulatory group, in patients who scored lower in the Medical Research Council (MRC) scores, and in patients whose the MRC scores for the lower limbs were lower than of the upper limbs. We observed that a decrease in the DSPAU was associated with an improvement in functional assessment parameters following rehabilitation. Further, changes in DSPAU were significantly correlated to the Modified Barthel Index. We observed that a decrease in DSPAU was associated with an improvement in functional parameters following rehabilitation. In conclusion, repeated measurements of sitting balance using DSPAU may be helpful to predict motor and functional recovery in stroke patient with hemiplegia.
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Affiliation(s)
- Da-Sol Kim
- Department of Physical Medicine & Rehabilitation, Chonbuk National University Medical School, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Myoung-Hwan Ko
- Department of Physical Medicine & Rehabilitation, Chonbuk National University Medical School, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.,Translational Research & Clinical Trial Center for Medical Device, Chonbuk National University Hospital, Jeonju, Korea
| | - Yu Hui Won
- Department of Physical Medicine & Rehabilitation, Chonbuk National University Medical School, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Sung-Hee Park
- Department of Physical Medicine & Rehabilitation, Chonbuk National University Medical School, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Jeong-Hwan Seo
- Department of Physical Medicine & Rehabilitation, Chonbuk National University Medical School, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.,Translational Research & Clinical Trial Center for Medical Device, Chonbuk National University Hospital, Jeonju, Korea
| | - Gi-Wook Kim
- Department of Physical Medicine & Rehabilitation, Chonbuk National University Medical School, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.,Translational Research & Clinical Trial Center for Medical Device, Chonbuk National University Hospital, Jeonju, Korea
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Fukuzawa I, Tokumaru O, Eshima N, Bacal K, Kitano T, Yokoi I. Re-employment of people with chronic stroke: A single-centre retrospective study. Aust Occup Ther J 2018; 65:598-605. [PMID: 30334583 DOI: 10.1111/1440-1630.12523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM Re-employment is the goal of rehabilitation for many patients after stroke. This study retrospectively examined previously employed stroke survivors who were unable to return to work at time of discharge from hospital and identified factors which were correlated with successful re-employment following a rehabilitation programme involving occupational therapy at a support facility. Factors correlated with reactivation of drivers' licence after stroke were also investigated. METHODS Participants were 150 post-stroke patients who were discharged from a support facility for persons with disabilities from April 2011 to March 2016. Data on patients' sociodemographic information, activities of daily living, and physical functions had been recorded at the time of admission into the facility. Employment status was recorded at discharge. Data were collected retrospectively in July 2017 from the medical records. Logistic regression models were prepared to examine factors correlated with successful re-employment and reactivation of drivers' licence after occupational therapy. RESULTS A stepwise logistic regression model revealed that the following four factors were significantly correlated with successful re-employment: (i) the dressing-lower body item in the Functional Independence Measure (P < 0.001), (ii) the grooming item in the Functional Independence Measure (P = 0.002), (iii) marital status (P = 0.007), and (iv) the problem-solving item in the Functional Independence Measure (P = 0.028). Another stepwise logistic regression model revealed that the factors were significantly correlated with successful reactivation of drivers' licence: (i) the problem-solving item in the Functional Independence Measure (P = 0.002), (ii) the dressing-lower body item in the Functional Independence Measure (P = 0.011) and (iii) the residence area (P = 0.038). CONCLUSION A single-centre retrospective study demonstrated several significant correlates of successful re-employment and reactivation of drivers' licence after stroke following rehabilitation training which employs occupational therapy to target skills critical for employment.
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Affiliation(s)
- Itaru Fukuzawa
- Department of Anaesthesiology, Oita University Faculty of Medicine, Oita, Japan.,Support Facility for Persons with Disabilities "Niji", Beppu Rehabilitation Centre, Oita, Japan
| | - Osamu Tokumaru
- Faculty of Welfare and Health Sciences, Oita University, Oita, Japan
| | | | - Kira Bacal
- Medical Programme Directorate, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Takaaki Kitano
- Department of Anaesthesiology, Oita University Faculty of Medicine, Oita, Japan
| | - Isao Yokoi
- Department of Neurophysiology, Oita University Faculty of Medicine, Oita, Japan
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10
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Vincent-Onabajo G, Joseph E, Musa HY. Impact of balance on functional independence after stroke: A cross-sectional study at rehabilitation settings in Nigeria. NeuroRehabilitation 2018; 42:499-504. [PMID: 29660950 DOI: 10.3233/nre-172305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Functional independence is often compromised after stroke and its restoration is one of the goals of stroke rehabilitation. OBJECTIVE This study assessed the impact of balance on functional independence after stroke. METHODS Ninety-five stroke patients undergoing physical rehabilitation at two health institutions in Nigeria participated in the study. Balance and functional independence were respectively assessed with the Berg Balance Scale and the Barthel Index. Binary logistic regression analysis was conducted to examine the independent impact of balance on functional independence while controlling for participants' age, sex, side of hemiparesis and post-stroke duration. RESULTS Mean±SD age of the participants was 58.4±13.1 years and females were more (f = 48; % = 50.5). The regression model from the binary regression analysis explained 73.2% (Nagelkerke R2 = 0.732) of the variance in functional independence. Good balance function was found to independently and significantly (P < 0.01) increase the likelihood of being functionally independent after stroke (Odds ratio = 1.33; 95% CI = 1.11 to 1.58). CONCLUSION The goal of attaining functional independence after stroke may depend to a significant extent on good balance function irrespective of the stroke survivor's age, sex and post-stroke duration.
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Affiliation(s)
- Grace Vincent-Onabajo
- Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Emmanuel Joseph
- Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Hadiza Yakubu Musa
- Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
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11
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Henstra MJ, Feenstra TC, van der Velde N, van der Mast RC, Comijs H, Stek ML, Rhebergen D. Apathy Is Associated With Greater Decline in Subjective, but not in Objective Measures of Physical Functioning in Older People Without Dementia. J Gerontol A Biol Sci Med Sci 2018; 74:254-260. [DOI: 10.1093/gerona/gly014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 02/01/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marieke Jantien Henstra
- Department of Internal Medicine, Geriatrics, Academic Medical Center Amsterdam, The Netherlands
- Academic Medical Center, University of Amsterdam, The Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health Research Institute, The Netherlands
| | - Thomas Christiaan Feenstra
- Department of Psychiatry, GGZ inGeest, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research VU Medical Center, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, The Netherlands
| | - Nathalie van der Velde
- Academic Medical Center, University of Amsterdam, The Netherlands
- Department of Internal Medicine, Geriatrics, Academic Medical Center Amsterdam, The Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health Research Institute, The Netherlands
| | - Roos C van der Mast
- Department of Psychiatry, Leiden University Medical Center, The Netherlands
- Department of Psychiatry, CAPRI-University of Antwerp, Belgium
| | - Hannie Comijs
- GGZ inGeest/Department of Psychiatry, Amsterdam Public Health Research Institute, VU Medical Center, The Netherlands
| | - Max L Stek
- GGZ inGeest/Department of Psychiatry, Amsterdam Public Health Research Institute, VU Medical Center, The Netherlands
| | - Didi Rhebergen
- GGZ inGeest/Department of Psychiatry, Amsterdam Public Health Research Institute, VU Medical Center, The Netherlands
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Koh DJ, Kim NY, Kim YW. Predictors of Depressive Mood in Patients With Isolated Cerebellar Stroke: A Retrospective Study. Ann Rehabil Med 2016; 40:412-9. [PMID: 27446777 PMCID: PMC4951359 DOI: 10.5535/arm.2016.40.3.412] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 09/25/2015] [Indexed: 11/08/2022] Open
Abstract
Objective To identify predictive factors of depressive mood in patients with isolated cerebellar stroke. Methods A retrospective chart review was performed in patients who had experienced their first isolated cerebellar stroke during 2002–2014. The patients were classified into two groups by the Geriatric Depression Scale (GDS) (non-depressive group, 0≤GDS≤16; depressive group, 17≤GDS≤30). Data on demographic and socioeconomic factors, comorbidities, functional level, cognitive and linguistic function, and stroke characteristics were collected. Significant variables in univariate analysis were analyzed using logistic regression. Results Fifty-two patients were enrolled, of whom 55.8% had depressive mood, were older (p=0.021), and had higher hypertension rates (p=0.014). Cognitive and linguistic functions did not differ between the two groups. The depressive group had higher ischemic stroke rates (p=0.035) and showed a dominant right posterior cerebellar hemisphere lesion (p=0.028), which was independently associated with depressive mood in the multiple logistic regression analysis (odds ratio, 5.081; 95% confidence interval, 1.261–20.479). Conclusion The risk of depressive mood after cerebellar stroke was increased in patients at old age, with a history of hypertension, ischemic stroke, and lesion of the right posterior cerebellar hemisphere. The most significant determining factor was stroke lesion of the right posterior cerebellar hemisphere. Early detection of risk factors is important to prevent and manage depressive mood after cerebellar stroke.
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Affiliation(s)
- Dong Jin Koh
- Department of Rehabilitation Medicine and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine & Severance Hospital, Seoul, Korea
| | - Na Young Kim
- Department of Rehabilitation Medicine and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine & Severance Hospital, Seoul, Korea
| | - Yong Wook Kim
- Department of Rehabilitation Medicine and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine & Severance Hospital, Seoul, Korea
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Effect of Tramadol/Acetaminophen on Motivation in Patients with Chronic Low Back Pain. Pain Res Manag 2016; 2016:7458534. [PMID: 27445626 PMCID: PMC4904595 DOI: 10.1155/2016/7458534] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 12/30/2015] [Indexed: 11/18/2022]
Abstract
Background. The contribution of apathy, frequently recognized in individuals with neurodegenerative diseases, to chronic low back pain (LBP) remains unclear. Objectives. To investigate levels of apathy and clinical outcomes in patients with chronic LBP treated with tramadol-acetaminophen. Methods. A retrospective case-control study involving 73 patients with chronic LBP (23 male, 50 female; mean age 71 years) treated with tramadol-acetaminophen (n = 36) and celecoxib (n = 37) was performed. All patients were assessed using the self-reported questionnaires. A mediation model was constructed using a bootstrapping method to evaluate the mediating effects of pain relief after treatment. Results. A total of 35 (55.6%) patients met the criteria for apathy. A four-week treatment regimen in the tramadol group conferred significant improvements in the Apathy scale and numerical rating scale but not in the Rolland-Morris Disability Questionnaire, Pain Disability Assessment Scale, or Pain Catastrophizing Scale. The depression component of the Hospital Anxiety and Depression Scale was lower in the tramadol group than in the celecoxib group. The mediation analysis found that the impact of tramadol-acetaminophen on the change in apathy was not mediated by the pain relief. Conclusions. Tramadol-acetaminophen was effective at reducing chronic LBP and conferred a prophylactic motivational effect in patients with chronic LBP.
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Ferreira MS, Chamlian TR, França CN, Massaro AR. Non-motor Factors Associated with the Attainment of Community Ambulation after Stroke. Clin Med Res 2015; 13:58-64. [PMID: 25380611 PMCID: PMC4504659 DOI: 10.3121/cmr.2014.1232] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 06/30/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Detect the main predictive non-motor factors related to independent community ambulation after stroke. Furthermore, we propose a scale to estimate the probability of a stroke patient achieving independent community ambulation after 6 months of rehabilitation. DESIGN AND SETTINGS Prospective cohort. Subjects treated in a rehabilitation center in a large metropolitan area. Independent community ambulation was evaluated after rehabilitation according to the Hoffer classification. Functional ambulation was assessed at four levels: nonambulatory, nonfunctional ambulation, household ambulation, and community ambulation. PARTICIPANTS Patients (n=201) with a moderate disability after stroke. RESULTS The average time of hospitalization was 19.3 days. However, only 32.8% of the patients started the rehabilitation program during the first 6 months after stroke. We found that 121 patients achieved community ambulation (60.2%), 40 achieved household ambulation (19.9%), 12 achieved therapeutic ambulation (5.9%), and 28 were non-ambulatory after 6 months of treatment. Based on our final model, a scoring scale was created in order to evaluate the probability of stroke patients achieving independent community ambulation after 6 months of rehabilitation. Higher scores were associated with better chances of community ambulation within 6 months. CONCLUSIONS The scale that evaluated these factors proved to have acceptable sensitivity and specificity to establish the prognosis of community ambulation after 6 months of rehabilitation.
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Affiliation(s)
- Milene Silva Ferreira
- Federal University of Sao Paulo, Sao Paulo, Brazil Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | | | - Carolina Nunes França
- Cardiology Division, Federal University of Sao Paulo, Brazil Santo Amaro University, Sao Paulo, Brazil
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Jeong J, Park DS, Lee H, Eun S. A reliability of the prototype trunk training system for sitting balance. J Phys Ther Sci 2014; 26:1745-7. [PMID: 25435691 PMCID: PMC4242946 DOI: 10.1589/jpts.26.1745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 05/16/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Cerebral palsy is a disorder that affects balance in the sitting position.
Cerebral palsy patients need trunk muscle strengthening and balance training. In order to
improve trunk control sensory-motor control training is carried out on an unstable
surface. We have developed a Trunk Training System (TTS) that can provide visual feedback
using a tilt sensor for balance training in the sitting position. Before using the TTS for
training children with cerebral palsy experiments were conducted with healthy adult
subjects and the TTS to gather basic data for its improvement. [Subjects] The subjects
were 11 healthy men (n=3) and women (n=8). [Methods] Subjects trained at two levels (5°,
10°), in four different directions (anterior, posterior, left, right), three times each.
TTS outcome indices (stability index, performance time) were measured. [Results] The
stability index and performance time showed high correlation (−0.6<r<1). The
measurements of the different task levels and directions showed high reliability
(0.9<α). [Conclusion] The TTS may be used to evaluate the range of motion and execution
capabilities of sitting balance. Additional experiments will be needed to investigate the
validity of the TTS measurements.
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Affiliation(s)
- Juri Jeong
- Department of Motor and Cognition Rehabilitation, Korea National Rehabilitation Center, Republic of Korea
| | - Dae-Sung Park
- Department of Motor and Cognition Rehabilitation, Korea National Rehabilitation Center, Republic of Korea
| | - Hyelim Lee
- Department of Motor and Cognition Rehabilitation, Korea National Rehabilitation Center, Republic of Korea
| | - Seondeok Eun
- Department of Motor and Cognition Rehabilitation, Korea National Rehabilitation Center, Republic of Korea
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Dhiman NR, Shah GL, Joshi D, Gyanpuri V. Relationship between side of hemiparesis and functional independence using activities of daily living index. J ANAT SOC INDIA 2014. [DOI: 10.1016/j.jasi.2014.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Huang SW, Wang WT, Yang TH, Liou TH, Chen GY, Lin LF. The Balance Effect of Acupuncture Therapy Among Stroke Patients. J Altern Complement Med 2014; 20:618-22. [DOI: 10.1089/acm.2014.0003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wei-Te Wang
- Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan
| | - Tsung-Hsien Yang
- Department of Chinese Acupuncture and Traumatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Injury Prevention, Taipei Medical University, Taipei, Taiwan
| | - Guan-Yu Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Li-Fong Lin
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
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Caeiro L, Ferro JM, Pinho e Melo T, Canhão P, Figueira ML. Post-Stroke Apathy: An Exploratory Longitudinal Study. Cerebrovasc Dis 2013; 35:507-13. [DOI: 10.1159/000350202] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 02/20/2013] [Indexed: 11/19/2022] Open
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O'Dell MW, Au J, Schwabe E, Batistick H, Christos PJ. A Comparison of Two Balance Measures to Predict Discharge Performance From Inpatient Stroke Rehabilitation. PM R 2013; 5:392-9. [DOI: 10.1016/j.pmrj.2013.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 01/23/2013] [Accepted: 02/03/2013] [Indexed: 11/26/2022]
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Caeiro L, Ferro JM, Costa J. Apathy Secondary to Stroke: A Systematic Review and Meta-Analysis. Cerebrovasc Dis 2013; 35:23-39. [DOI: 10.1159/000346076] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 11/22/2012] [Indexed: 11/19/2022] Open
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Buijck BI, Zuidema SU, Spruit-van Eijk M, Geurts ACH, Koopmans RTCM. Neuropsychiatric symptoms in geriatric patients admitted to skilled nursing facilities in nursing homes for rehabilitation after stroke: a longitudinal multicenter study. Int J Geriatr Psychiatry 2012; 27:734-41. [PMID: 21932248 DOI: 10.1002/gps.2781] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 07/11/2011] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate the prevalence and course of neuropsychiatric symptoms (NPS) in geriatric patients admitted to skilled nursing facilities (SNFs) for rehabilitation after stroke. METHODS This was a longitudinal multicenter study within 15 SNFs in the Netherlands. NPS were assessed in 145 patients with stroke through the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) with measurements on admission and at discharge. The prevalence and course of NPS were described in terms of cumulative prevalence (symptoms either on admission or at discharge), conversion (only symptoms at discharge), remission (only symptoms on admission), and persistence (symptoms both on admission and at discharge) for patients who were discharged to an independent living situation within one year after admission and patients who had to stay in the SNF for long term care. RESULTS Eighty percent had a first-ever stroke and 74% could be successfully discharged. Overall, the most common NPS were depression (33%), eating changes (18%), night-time disturbances (19%), anxiety (15%), irritability (12%), and disinhibition (12%). One year after admission, the patients who were still in the SNF showed significantly more hallucinations (p = 0.016), delusions (p = 0.016), agitation (p = 0.004), depression (p = 0.000), disinhibition (p = 0.004), irritability (p = 0.018), and night-time disturbances (p = 0.001) than those who had been discharged. DISCUSSION The overall prevalence of NPS in this study was lower than reported by other studies in different settings. There was a high prevalence of NPS in patients that could not be successfully discharged. CONCLUSIONS The findings suggest that NPS should be optimally treated to improve outcome of rehabilitation.
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Affiliation(s)
- Bianca I Buijck
- Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. .
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Hama S, Yamashita H, Yamawaki S, Kurisu K. Post-stroke depression and apathy: Interactions between functional recovery, lesion location, and emotional response. Psychogeriatrics 2011; 11:68-76. [PMID: 21447112 DOI: 10.1111/j.1479-8301.2011.00358.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Depression and apathy are often observed after stroke and are often confused with one another. In the present review, we argue that the current concept of 'post-stroke depression' (PSD) in fact consists of two core symptoms or syndromes: (i) affective (depressive) PSD; and (ii) apathetic PSD. We argue that these two core symptoms are each associated with a different underlying neuroanatomical mechanism, a pattern that influences functional recovery. Post-stroke disabilities can provoke several distinct emotional responses, some of which are associated with severe depression. We examined one of these emotional responses previously, namely 'insistence on recovery', which was believed to be a negative indicator of functional improvement in disabled stroke patients. However, an appropriate level of insistence on recovery may, in fact, be associated with reduced depression and apathy, resulting in enhanced recovery from stroke-related disabilities. Improvements in physical disabilities (trunk stability or activities of daily living, such as walking) also reduce depression and apathy. Therefore, the experience of PSD/apathy may be intertwined with various initial emotional responses and improvements in physical functioning. Effective treatment of PSD/apathy requires a multidisciplinary approach, such that neuroanatomical/neurobiological, emotional, and physical (rehabilitation) domains are all addressed.
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Affiliation(s)
- Seiji Hama
- Department of Neurosurgery, Graduate School of Biomedical Science, Hiroshima, University, Japan.
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Hama S, Yamashita H, Kato T, Shigenobu M, Watanabe A, Sawa M, Kurisu K, Yamawaki S, Kitaoka T. 'Insistence on recovery' as a positive prognostic factor in Japanese stroke patients. Psychiatry Clin Neurosci 2008; 62:386-95. [PMID: 18778435 DOI: 10.1111/j.1440-1819.2008.01816.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM The present study used two-step analyses to examine the effect of acceptance of disability or 'insistence on recovery' in Japanese stroke patients: first on their functional improvement and second, on their psychological symptoms. METHODS Disability was assessed using functional independence measurements (FIM), examining the stage of acceptance of disability by observation using Fink's theory (from shock to defensive retreat, acknowledgement, and acceptance/change stage), and estimation of insistence on recovery (on a scale of 1-4) by observation. The differences over time and the effects on the improvement in their FIM were then assessed. Depression was measured using the Zung Self-rating Depression Scale (SDS); apathy was measured using the Apathy Scale (AS), and the correlation with the acceptance stage or insistence on recovery was analyzed. RESULTS The acceptance stage and functional improvement progressed significantly, but insistence on recovery did not change significantly during hospitalization. Multiple regression indicated that the insistence on recovery score (but not the acceptance stage) was a good predictor of the degree of improvement in FIM (FIM gain per week) in the elderly group. Post-hoc testing showed that the SDS or AS score decreased from the first stage to the fourth stage (but increased at the third stage) of acceptance; whereas for insistence on recovery score, the SDS and AS scores decreased as insistence on recovery score changed from 1 to 3, and then increased as insistence on recovery score changed from 3 to 4. CONCLUSIONS The appropriate level of insistence on recovery reduced depression and apathy, resulting in enhanced improvement of disability after a stroke in elderly stroke patients.
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Affiliation(s)
- Seiji Hama
- Department of Rehabilitation, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan.
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