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      • Record: found
      • Abstract: found
      • Article: found
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      CHANGES IN PERCEIVED IMPACT OF STROKE ON EVERYDAY LIFE OVER FIVE YEARS IN A REHABILITATION SAMPLE THAT RECEIVED AN ACTIVITY OF DAILY LIVING INTERVENTION: A FOLLOW-UP STUDY

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          Abstract

          Objective

          To compare changes in the perceived impact of stroke on everyday life over time in a rehabilitation sample that received a client-centred activities of daily living (CADL) intervention or usual ADL (UADL) intervention.

          Design

          Longitudinal follow-up of a randomized controlled trial.

          Methods

          A total of 145 persons with stroke were assigned into CADL or UADL. Groups were assessed using the Stroke Impact Scale (SIS) at 3 months, 12 months and 5 years post-intervention. Changes in SIS domain scores over time were compared within and between groups.

          Results

          Changes in the impact of stroke over time were not related to which intervention the groups received. There were no significant differences in the SIS domains or stroke recovery between groups at the 3-month, 12-month and 5-year follow-ups. Despite an increased impact of stroke over time in some domains in both groups, both groups perceived a decreased impact of stroke in the Participation domain at 12 months. Perceived participation was sustained at the same level at 12 months as at 5 years in both groups.

          Conclusion

          These findings stress the importance of access to follow-up rehabilitation interventions 1-year post-stroke to enable participation in daily activities. Such follow-up and enablement would support the use of self-management strategies in the performance of persons’ valued activities, which might be difficult to perform, due to, for example, impact on hand function or mobility. The results of this study emphasize the importance of prioritizing participation in activities that are meaningful from a personal perspective.

          LAY ABSTRACT

          In this study, perceived impact of stroke on everyday life over time was compared among 145 persons with stroke who received the client-centred or usual activities of daily living intervention. They were followed up at 3, 12 months and 5-years post-stroke. No differences were found in the impact of stroke over time between groups. Despite increased impact of stroke (indicating more problems) over time in some areas, the groups perceived decreased impact of stroke (less problems) in their participation at 12 months. Perceived participation was sustained at the same level at 12 months as at 5 years in both groups. Findings stress the importance of access to follow-up rehabilitation interventions one-year post-stroke to enable participation in daily activities, and to support the use of self-management strategies to facilitate participation in valued and meaningful activities that might be difficult due to person’s functional limitations.

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          Most cited references35

          • Record: found
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          "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.

          M F Folstein, S Folstein, P R McHugh (1975)
          Article 0 comments Cited 3418 times – based on 0 reviews     Review now
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            • Record: found
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            Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

            Catherine Owens Johnson, Minh Tri Nguyen, Gregory A Roth … (2019)
            Summary Background Stroke is a leading cause of mortality and disability worldwide and the economic costs of treatment and post-stroke care are substantial. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic, comparable method of quantifying health loss by disease, age, sex, year, and location to provide information to health systems and policy makers on more than 300 causes of disease and injury, including stroke. The results presented here are the estimates of burden due to overall stroke and ischaemic and haemorrhagic stroke from GBD 2016. Methods We report estimates and corresponding uncertainty intervals (UIs), from 1990 to 2016, for incidence, prevalence, deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs). DALYs were generated by summing YLLs and YLDs. Cause-specific mortality was estimated using an ensemble modelling process with vital registration and verbal autopsy data as inputs. Non-fatal estimates were generated using Bayesian meta-regression incorporating data from registries, scientific literature, administrative records, and surveys. The Socio-demographic Index (SDI), a summary indicator generated using educational attainment, lagged distributed income, and total fertility rate, was used to group countries into quintiles. Findings In 2016, there were 5·5 million (95% UI 5·3 to 5·7) deaths and 116·4 million (111·4 to 121·4) DALYs due to stroke. The global age-standardised mortality rate decreased by 36·2% (−39·3 to −33·6) from 1990 to 2016, with decreases in all SDI quintiles. Over the same period, the global age-standardised DALY rate declined by 34·2% (−37·2 to −31·5), also with decreases in all SDI quintiles. There were 13·7 million (12·7 to 14·7) new stroke cases in 2016. Global age-standardised incidence declined by 8·1% (−10·7 to −5·5) from 1990 to 2016 and decreased in all SDI quintiles except the middle SDI group. There were 80·1 million (74·1 to 86·3) prevalent cases of stroke globally in 2016; 41·1 million (38·0 to 44·3) in women and 39·0 million (36·1 to 42·1) in men. Interpretation Although age-standardised mortality rates have decreased sharply from 1990 to 2016, the decrease in age-standardised incidence has been less steep, indicating that the burden of stroke is likely to remain high. Planned updates to future GBD iterations include generating separate estimates for subarachnoid haemorrhage and intracerebral haemorrhage, generating estimates of transient ischaemic attack, and including atrial fibrillation as a risk factor. Funding Bill & Melinda Gates Foundation
            Article 0 comments Cited 967 times – based on 0 reviews     Review now
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              Rasch analysis of a new stroke-specific outcome scale: the Stroke Impact Scale.

              Pamela Duncan, Rita Bode, Sue Min Lai … (2003)
              To assess multiple psychometric characteristics of a new stroke outcome measure, the Stroke Impact Scale (SIS), using Rasch analysis, and to identify and remove misfitting items from the 8 domains that comprise the SIS. Secondary analysis of 3-month outcomes for the Glycine Antagonist in Neuroprotection (GAIN) Americas randomized stroke trial. A multicenter randomized trial performed in 132 centers in the United States and Canada. A total of 696 individuals with stroke who were community-dwelling and independent prior to acute stroke. Not applicable. Rasch analysis was performed using WINSTEPS, version 3.31, to evaluate 4 psychometric characteristics of the SIS: (1) unidimensionality or fit (the extent to which items measure a single construct), (2) targeting (the extent to which the items are of appropriate difficulty for the sample), (3) item difficulty (the ordering of items from least to most difficult to perform), and (4) separation (the extent to which the items distinguish distinct levels of functioning within the sample). (1) Within each domain, most of the items measured a single construct. Only 3 items misfit the constructs and were deleted ("add and subtract numbers," "get up from a chair," "feel emotionally connected") and 2 items ("handle money," "manage money") misfit the combined physical domain. These items were deleted to create SIS, version 3.0. (2) Overall, the items are well targeted to the sample. The physical and participation domains have a wide range of items that capture difficulties that most individuals with stroke experience in physical and role functions, while the memory, emotion, and communication domains include items that capture limitations in the most impaired patients. (3) The order of items from less to more difficult was clinically meaningful. (4) The individual physical domains differentiated at least 3 (high, average, low) levels of functioning and the composite physical domain differentiated more than 4 levels of functioning. However, because difficulties with communication, memory, and emotion were not as frequently reported and difficulties with hand function were more frequently reported, these domains only differentiated 2 (high, low) to 3 (high, average, low) strata of patients. Time from stroke onset to administration of the SIS had little effect on item functioning. Rasch analysis further established the validity of the SIS. The domains are unidimensional, the items have an excellent range of difficulty, and the domain scores differentiated patients into multiple strata. The activities of daily living/instrumental activities of daily living, mobility, strength, composite physical, and participation domains have the most robust psychometric characteristics. The composite physical domain is most able to discriminate difficulty in function in individuals after stroke, while the communication, memory, and emotion domain items only capture limitations in function in the more impaired groups of patients.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Rehabil Med
                Journal ID (iso-abbrev): J Rehabil Med
                Journal ID (publisher-id): JRM
                Title: Journal of Rehabilitation Medicine
                Publisher: Medical Journals Sweden AB
                ISSN (Print): 1650-1977
                ISSN (Electronic): 1651-2081
                Publication date (Electronic): 20 June 2022
                Publication date Collection: 2022
                Volume: 54
                Electronic Location Identifier: 1060
                Affiliations
                [1 ]Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm
                [2 ]Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
                Author notes
                Correspondence address: Mandana Fallahpour, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Fack 23200, SE-141 83 Huddinge, Stockholm, Sweden. E-mail: Mandana.Fallahpour@ 123456ki.se
                Article
                Publisher ID: 1060
                DOI: 10.2340/jrm.v54.1060
                PMC ID: 9252091
                PubMed ID: 35582945
                SO-VID: ca45f1c0-b668-4758-b356-02f2c0d52d95
                Copyright © © Published by Medical Journals Sweden, on behalf of the Foundation for Rehabilitation Information
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/)

                History
                Date accepted : 20 April 2022
                Categories
                Subject: Original Report

                Keywords: stroke,participation,everyday life,daily activities,rehabilitation,occupational therapy,follow-up studies,longitudinal studies
                Data availability:
                Keywords: stroke, participation, everyday life, daily activities, rehabilitation, occupational therapy, follow-up studies, longitudinal studies

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