Factors affecting outcome in participation one year after stroke: A secondary analysis of a randomized controlled trial

Gustavsson, Mikael K.; Guidetti, Susanne; Eriksson, Gunilla; Koch, Lena von; Ytterberg, Charlotte

doi:10.2340/16501977-2523

Cited by 10 publications

(14 citation statements)

References 25 publications

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“…This further supports the need to use multiple measures to provide a comprehensive assessment of different aspects of participation. This is consistent with recommendations by others (11, 32).…”

Section: Discussionsupporting

confidence: 93%

Participation in Younger and Older Adults Post-stroke: Frequency, Importance, and Desirability of Engagement in Activities

et al. 2019

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Purpose: To characterize and compare frequency and subjective dimensions of post-stroke participation in younger (<65) and older adults (>age 65), in social, productivity and leisure activities, 6 months post-inpatient rehabilitation. Secondary aims included exploration of demographic and clinical factors influencing desire for increased participation and comparison of two measures of participation.Methods: A prospective cohort study of people with stroke (n = 99) who were identified during their inpatient rehabilitation stay and followed-up 6 months post-discharge with telephone interviews using two self-report participation measures. The Stroke Impact Participation subscale (SIS-P) measured the frequency of perceived limitations in social, leisure, productive activities and extent of stroke recovery. The Community Participation Indicators (CPI) examined activity frequency, importance, and desire for increased activity engagement. Descriptive statistics were used to summarize demographic variables and characterize SIS-P and CPI items. Differences between age groups on individual items were examined. Associations between measures and demographic variables were explored.Results: Both groups reported a wide variation in participation restrictions that was not associated with stroke severity and weakly associated with discharge functional status (rho = 0.20–0.35). There were no significant differences between age groups in CPI frequency (for 18/19 items), or the SIS-P. However, there was a trend toward more participation restrictions on the SIS-P among those <65 (p = 0.07). Younger adults (n = 46; median age = 53) were significantly more likely to indicate that they were not doing selected activities enough on the CPI, compared with older adults (n = 56; median age = 76). While age and ethnicity were independently associated with some activities, it was not associated with other activities. The CPI and SIS-P were moderately related at a correlation of rho = 0.54, p < 0.001.Conclusion: The CPI demonstrated value and utility in examining subjective perspectives of activity importance and desire for change for people who are 6 months post-stroke. Although the CPI and SIS-P are moderately related, subjective appraisal of participation in selected individual activities (CPI) better distinguished between age groups and provided unique and distinct information from the SIS-P.

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Section: Discussionsupporting

confidence: 93%

Participation in Younger and Older Adults Post-stroke: Frequency, Importance, and Desirability of Engagement in Activities

et al. 2019

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“…before 2009). We therefore found it important to report on how we developed the theoretical base and modelled the content of the new and complex ADL intervention, before the effectiveness of the intervention was evaluated in an RCT [5][6][7][8][9]. Nevertheless, developing and evaluating a new and complex client-centred intervention has been a long process involving multiple phases.…”

Section: Discussionmentioning

confidence: 99%

“…The effects of the CADL have been evaluated in a randomized controlled trial (RCT) (ClinicalTrials.gov NCT01417585) and the CONSORT Statement [2] has been used to report the trial. The findings from the RCT were presented in both qualitative [3,4] and quantitative studies [5][6][7][8][9]. However, the development, rationale and content of the intervention have been requested but have not yet been presented in detail.…”

Section: Introductionmentioning

confidence: 99%

Activities in Daily Living: The development of a new client-centred ADL intervention for persons with stroke

Guidetti

Eriksson

Koch

et al. 2020

Scandinavian Journal of Occupational Therapy

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“…Stroke survivors often experience participation restrictions in the chronic phase, despite having favorable basic ADLs [17]. Several factors contribute to participation restriction after stroke, including cognitive impairment, emotional de cits, stroke severity, functional dependency, and older age [30,31]. We hypothesize that the contribution of END to impaired participation may be in uenced by comprehensive risk factors.…”

Section: Discussionmentioning

confidence: 99%

Effects of Early Neurological Deterioration in Acute Ischemic Stroke on Multiple Dimensions of Functional Outcomes using Propensity Score Matching Analysis

Qu¹,

Zhong²,

Liang³

et al. 2020

Preprint

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Background: Early neurological deterioration (END) is common in acute ischemic stroke (AIS), but its effect on functional outcomes is not well understood. Here, we explored the effects of END on multiple dimensions of functional outcomes.Methods: 256 patients with AIS were analyzed. All patients were followed up for 1 year. We used the modified Rankin Scale (mRS) to assess body function impairment, the Lawton activities of daily living scale to assess activity limitations, and the reintegration to normal living index (RNLI) to assess participation restrictions. Brain MRI was performed to identify acute infarcts and preexisting abnormalities. To reduce the effects of a lack of randomization, we conducted a propensity score analysis. Results: Among 256 patients with AIS, 61(23.8%) patients had END. Before matching, patients with END had higher levels of small artery-type stroke, higher NIHSS scores on arrival, higher systolic blood pressure on admission, and larger infarct volumes. After matching, there were no significant differences between the two groups in any clinical or neuroimaging variables, except for stroke subtype and cortical region infarct. Logistic regression analysis revealed that END was a significant predictor of poor mRS (odds ratio [OR], 3.829; 95% confidence interval [CI], 1.367–10.723, p = 0.011) and poor RNLI (OR, 2.777; 95% CI, 1.133–6.806, p = 0.026) scores after adjusting for confounding factors.Conclusions: END is relatively common in AIS. END might be a significant predictor of poor functional outcomes, including body function impairment and reduced social participation.

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Factors affecting outcome in participation one year after stroke: A secondary analysis of a randomized controlled trial

Cited by 10 publications

References 25 publications

Participation in Younger and Older Adults Post-stroke: Frequency, Importance, and Desirability of Engagement in Activities

Participation in Younger and Older Adults Post-stroke: Frequency, Importance, and Desirability of Engagement in Activities

Activities in Daily Living: The development of a new client-centred ADL intervention for persons with stroke

Effects of Early Neurological Deterioration in Acute Ischemic Stroke on Multiple Dimensions of Functional Outcomes using Propensity Score Matching Analysis

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