Spasticity, Pain, and Fatigue

BACKGROUND: Backward walking speed is an objective index to evaluate motor ability, but it is not clear whether it can screen stroke patients with mobility disorders. This study aims to test the diagnostic efficacy of backward maximum walking speed (BMWS) and backward comfortable walking speed (BCWS) on mobility defects in stroke patients and obtain the cutoff values of them. METHODS: We conducted a cross-sectional study of poststroke patients who were hospitalized from July 2021 to January 2022. 98 poststroke patients were selected for 6 functional tests and divided into the high-mobility function group and low-mobility function group by K-means cluster analysis. According to the test results of BMWS and BCWS, the receiver operating characteristic curve was drawn to determine the cutoff values and compare the diagnostic efficiency of the 2 indexes. RESULTS: The BMWS of stroke patients was 0.54 (0.29) m/s, and the BCWS was 0.37 (0.19) m/s. Receiver operating characteristic results showed that the cutoff value of BMWS for the diagnosis of mobility impairment in stroke patients was 0.3 m/s, the area under the curve was 0.95 (95% confidence interval, 0.89-0.98), the specificity was 0.86, and the sensitivity was 0.93. The cutoff value of BCWS was 0.27 m/s, the area under the curve was 0.91 (95% confidence interval, 0.84-0.96), the specificity was 0.91, and the sensitivity was 0.8. There was no significant difference between the 2 indexes in the diagnosis of mobility defects in stroke patients ( P > .05). CONCLUSIONS: Backward walking speed is a useful indicator for discriminating stroke patients with mobility deficits. Considering the risks associated with backward walking, BCWS can be used in clinical assessments to guide nurses in the development and implementation of rehabilitation programs.

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Study on the Cutoff Value of Backward Walking Speed to Distinguish the Mobility Deficits of Stroke Patients

Peng

Teng

Lin

et al. 2022

Journal of Neuroscience Nursing

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Fatigue Experiences in People With Stroke

Bhimani,

Xiong,

Anderson

2023

Rehabilitation Nursing

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Purpose Fatigue is a major symptom in patients with stroke. Because fatigue is an overarching multidimensional phenomenon, it is important to understand how the characteristics of fatigue change over time. The purpose of this study was to explore how fatigue characteristics change over time in patients with stroke. Design This study used a mixed-method observational design. Methods This study is a secondary analysis of data from a previous study, the results of which indicated fatigue to be a prominent symptom. Participants in that study were patients with stroke who met eligibility criteria and provided informed consent. This secondary analysis used data from numeric rating scale scores for fatigue, Functional Assessment of Chronic Illness Therapy–Fatigue Scale scores, fatigue descriptors, and participant comments about fatigue gleaned from transcribed interviews. Results Twenty-two patients participated in the study. Thirteen characteristics of fatigue were evaluated. Seven characteristics showed significant improvement (p < .05) from admission to 1 month follow-up, and six characteristics did not change significantly. Conclusions Fatigue experiences vary over time and have both physical and mental aspects to them. Clinical Relevance to Rehabilitation Nursing Nurses may consider providing a quiet environment for physical rest, which may allow the brain to not be distracted by multiple stimuli.

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Post‐stroke fatigue, hope and discharge readiness: A cross‐sectional survey

Xian yi,

Shuang,

Jie

et al. 2024

Journal of Clinical Nursing

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Aims and ObjectivesTo explore the relationships among post‐stroke fatigue, hope and discharge readiness in stroke patients, and to determine whether hope mediates the relationship between post‐stroke fatigue and discharge readiness.BackgroundIn stroke patients, inadequate discharge readiness has been found to correlate with higher readmission and mortality rates. Although previous qualitative studies have confirmed the impact of fatigue on discharge readiness, few studies explore the impact of post‐stroke fatigue and hope on discharge readiness of stroke patients. Consequently, the current research on this relationship and its underlying mechanisms is still quite limited.DesignCross‐sectional study.MethodsData were collected from 340 stroke patients. The research tools included demographic and disease characteristics, Discharge Readiness Assessment Scale for Stroke, Neurological Fatigue Index for Stroke and Herth Hope Index. The STROBE checklist was used to guide the presentation of this study.ResultsDischarge readiness was negatively correlated with post‐stroke fatigue and positively correlated with hope. Additionally, post‐stroke fatigue was negatively correlated with hope. Post‐stroke fatigue had a direct negative effect on discharge readiness, and it can also generate indirect effects through hope. Hope was the partial mediator between post‐stroke fatigue and discharge readiness, explaining 55.8% of the total effect.ConclusionDischarge readiness of this population can be improved by reducing post‐stroke fatigue and increasing hope. Therefore, effective management of post‐stroke fatigue and hope will help improve discharge readiness.Relevance to Clinical PracticeIt is recommended that nursing staff should monitor the occurrence and development of post‐stroke fatigue in stroke patients, dynamically evaluate the patient's level of hope, and pay attention to the important role of positive psychological qualities in the outcome of discharge. If medical staff can formulate corresponding intervention measures based on the influence path of discharge readiness, then the discharge readiness of stroke patients can be improved.

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Spasticity, Pain, and Fatigue

Cited by 7 publications

References 62 publications

Study on the Cutoff Value of Backward Walking Speed to Distinguish the Mobility Deficits of Stroke Patients

Study on the Cutoff Value of Backward Walking Speed to Distinguish the Mobility Deficits of Stroke Patients

Fatigue Experiences in People With Stroke

Post‐stroke fatigue, hope and discharge readiness: A cross‐sectional survey

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